Individual provider Active NPI

Alexis Shelby Mullikin, MSN, FNP-BC

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1811589013
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0028565 Issued in OH
Practice address
4235 Secor Rd
Toledo, OH 43623-4231
Phone
(419) 479-5860
Fax
(419) 479-3971
NPI assigned
Feb 9, 2021
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704330336 MI
Family Nurse Practitioner 363LF0000X APRN.CNP.0028565 OH Primary

Addresses

Primary practice location

4235 Secor Rd
Toledo, OH 43623-4231

Mailing address

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 473-3561

Other practice location 1

3830 Woodley Rd Ste B
Toledo, OH 43606-1177
Phone (419) 473-9380

Other identifiers 1

IdentifierTypeStateIssuer
0439650MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210419001062 MI Practitioner - Nurse Practitioner 6204244908
I20210420002319 OH Practitioner - Nurse Practitioner 6204244908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Toledo Clinic IncorporatedGroup PAC ID 5698673382, 204 clinicians

Practice addresses (Care Compare)

3830 Woodley Rd
Suite C
Toledo, OH 43606-1177
Phone (419) 841-1600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated Current Accepting new patients
Toledo Clinic Incorporated CurrentSince May 19, 2022 Accepting new patients
Toledo Clinic Incorporated CurrentSince May 19, 2022 Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients
Toledo Clinic Incorporated Past Accepting new patients
West Toledo Urgent Care LLC Past Accepting new patients

Locations

3830 Woodley Rd
Ste B
Toledo, OH 43606
Phone (419) 473-9380

3830 Woodley Rd
Ste C
Toledo, OH 43606
Phone (419) 841-1600

4235 Secor Rd
Toledo, OH 43623
Phone (419) 214-4214

Organizations & group practices 8

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 3

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": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1811589013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234299",
            "telephone_number": "419-473-3561",
            "fax_number": "419-479-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 SECOR RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234231",
            "telephone_number": "419-479-5860",
            "fax_number": "419-479-3971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 Woodley Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436061177",
            "country_code": "US",
            "telephone_number": "419-473-9380",
            "fax_number": "419-473-9515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIKIN",
        "first_name": "ALEXIS",
        "middle_name": "SHELBY",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704330336",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0028565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0439650",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.