NPIMap

Individual provider Active NPI

Valerie Mullins, PA-C

  • Physician Assistant
  • Greeneville, TN
National Provider Identifier
1760775365
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1973 Issued in TN
Practice address
438 E Vann Rd
Suite 100
Greeneville, TN 37743-7202
Phone
(423) 278-1741
Fax
(423) 278-1742
NPI assigned
May 16, 2011
Last updated
Jun 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1973 TN Primary

Addresses

Primary practice location

438 E Vann Rd
Suite 100
Greeneville, TN 37743-7202

Mailing address

PO Box 37087
Baltimore, MD 21297-3087
Phone (828) 687-5616

Other identifiers 4

IdentifierTypeStateIssuer
4306949OtherTNBCBS OF TN
8102546MedicaidNC
1524312MedicaidTN
P00990206OtherTNRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110707000582 TN Practitioner - Physician Assistant 1355529736 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Takoma Regional Hospital IncGroup PAC ID 8729189295, 28 clinicians

Practice addresses (Care Compare)

1404 Tusculum Blvd
Suite 2200
Greeneville, TN 37745-4395
Phone (423) 783-5520

1424 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 783-5560

438 E Vann Rd
Greeneville, TN 37743-7202

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1973TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Takoma Regional Hospital, Inc CurrentSince Jul 18, 2011 Accepting new patients
Greeneville Emergency Physicians Medical Group PC Past Accepting new patients

Locations

1744 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 636-8891

401 Takoma Ave
Greeneville, TN 37743
Phone (423) 639-3151

438 E Vann Rd
Ste 100
Greeneville, TN 37743
Phone (423) 278-1700

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1760775365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37087",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973087",
            "telephone_number": "828-687-5616",
            "fax_number": "828-650-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 E VANN RD",
            "address_2": "SUITE 100",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377437202",
            "telephone_number": "423-278-1741",
            "fax_number": "423-278-1742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "VALERIE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4306949",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102546",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524312",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00990206",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeneville, TN

Sources for this page

Verify at the official NPI Registry.