NPIMap

Individual provider Active NPI

Penny L Mullins, M.D.

  • Family Medicine Physician
  • Old Fort, OH
National Provider Identifier
1730148099
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BM5446580 Issued in OH
Practice address
8153 Main Street
Old Fort, OH 44861
Phone
(419) 992-4231
Fax
(419) 992-4722
NPI assigned
Mar 23, 2006
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BM5446580 OH Primary

Addresses

Primary practice location

8153 Main Street
Old Fort, OH 44861

Mailing address

8153 Main Street
Old Fort, OH 44861
Phone (419) 992-4231

Other identifiers 1

IdentifierTypeStateIssuer
2034319MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Physician Billing LLC Past Accepting new patients
Marion General Hospital Foundation, Inc. Past Accepting new patients
Bowling Green State University Past Accepting new patients
Community and Rural Health Services Past Accepting new patients
Community Care I, Inc. Family Medicine Past Accepting new patients
Bowling Green State University Family Medicine Past Accepting new patients

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1730148099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8153 MAIN STREET",
            "city": "OLD FORT",
            "state": "OH",
            "postal_code": "44861",
            "telephone_number": "419-992-4231",
            "fax_number": "419-992-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8153 MAIN STREET",
            "city": "OLD FORT",
            "state": "OH",
            "postal_code": "44861",
            "telephone_number": "419-992-4231",
            "fax_number": "419-992-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "PENNY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "BM5446580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034319",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Fort, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.