Gwendolin B Mullins, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22722 Issued in TN

Practice address

5201 Kingston Pike Ste 6
Knoxville, TN 37919-5011

Phone

(865) 978-6182

Fax

(855) 737-5542

NPI assigned

Jun 20, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Gwendolin B Shaffer Former name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment NPD
• Summit Medical Group, PLLC

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1033425780
  NPD
• Summit Medical Group PLLC

  • Family Medicine Physician
  • Oak Ridge, TN
  • NPI 1437238797
  NPD (past)
• Summit Medical Group,PLLC

  • Internal Medicine Physician
  • Cookeville, TN
  • NPI 1588362164
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720508971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COMMERCE ST STE 700",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372011835",
            "telephone_number": "615-627-2293",
            "fax_number": "888-494-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 KINGSTON PIKE STE 6",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195011",
            "telephone_number": "865-978-6182",
            "fax_number": "855-737-5542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 E Weisgarber Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379092675",
            "country_code": "US",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 E Weisgarber Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379092675",
            "country_code": "US",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "GWENDOLIN",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "120275",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GWENDOLIN",
            "last_name": "SHAFFER",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheryl Rae Mullenbach
• Dawn Marie Mullens, RDH
• Isaiah Mullens, PTA
• Annia Mullins, PA
• Crickett Mullins, LPN
• Madison Riley Mullins
• Makenzee Lady Mullins
• Morgan Kristen Mullins
• Tracy Mullins, OTR
• Hayley Mullis, BCBA-D

• Family Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.