Individual provider Active NPI

William Stewart Mullin Jr., MS, PT

  • Physical Therapist
  • Richmond, VA
National Provider Identifier
1790725968
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305005443 Issued in VA
Practice address
McGuire Veterans Affairs Medical Center
1201 Broad Rock Boulevard
Richmond, VA 23249-0001
Phone
(804) 675-5000
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305005443 VA Primary

Addresses

Primary practice location

McGuire Veterans Affairs Medical Center
1201 Broad Rock Boulevard
Richmond, VA 23249-0001

Mailing address

11417 Orchard Park Dr
Apt. 121
Glen Allen, VA 23059-5547
Phone (804) 387-9985

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
Master of Science

State licenses

LicenseStateTypeSpecialty
2305005443VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790725968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11417 ORCHARD PARK DR",
            "address_2": "APT. 121",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595547",
            "telephone_number": "804-387-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MCGUIRE VETERANS AFFAIRS MEDICAL CENTER",
            "address_2": "1201 BROAD ROCK BOULEVARD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232490001",
            "telephone_number": "804-675-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIN",
        "first_name": "WILLIAM",
        "middle_name": "STEWART",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305005443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.