Individual provider Active NPI

Michael James Mullen, R.PH.

  • Pharmacist
  • High Point, NC
National Provider Identifier
1790073070
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
07372 Issued in NC
Practice address
2200 Westchester Dr
St 126
High Point, NC 27262-7099
Phone
(336) 881-1060
Fax
(336) 889-9293
NPI assigned
Jul 20, 2011
Last updated
Jul 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 07372 NC Primary
Pharmacist 183500000X 0202006146 VA
Pharmacist 183500000X 5538 SC

Addresses

Primary practice location

2200 Westchester Dr
St 126
High Point, NC 27262-7099

Mailing address

1111 Maplewood Ave
High Point, NC 27265-9145
Phone (336) 841-6461

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5538SCMDProfessional Counselor
07372NCMDPharmacist
0202006146VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1790073070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MAPLEWOOD AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272659145",
            "telephone_number": "336-841-6461",
            "fax_number": "336-841-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WESTCHESTER DR",
            "address_2": "ST 126",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627099",
            "telephone_number": "336-881-1060",
            "fax_number": "336-889-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-20",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "07372",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202006146",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "5538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.