Individual provider Active NPI

Preston Scott Mullens

  • Student in an Organized Health Care Education/Training Program
  • North Huntingdon, PA
National Provider Identifier
1821394172
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
12875 Route 30
Suite 25
North Huntingdon, PA 15642-2595
Phone
(724) 382-5576
NPI assigned
Feb 3, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

12875 Route 30
Suite 25
North Huntingdon, PA 15642-2595

Mailing address

12875 Route 30
North Huntingdon, PA 15642-2595
Phone (724) 382-5576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120320000165 PA Practitioner - Chiropractic 9436319076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12875 Route 30
Suite 25
North Huntingdon, PA 15642-1332
Phone (724) 382-5576

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Chiropractic and Rehabilitation LLC CurrentSince Apr 1, 2013 Accepting new patients
Greeley Chiropractic and Massage Past Accepting new patients
Revive Chiropractic and Rehablilitation LLC PastSince Oct 26, 2013 Accepting new patients

Locations

12875 Route 30
Ste 25
North Huntingdon, PA 15642
Phone (724) 382-5576

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368576000000",
    "number": "1821394172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12875 ROUTE 30",
            "city": "NORTH HUNTINGDON",
            "state": "PA",
            "postal_code": "156422595",
            "telephone_number": "724-382-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12875 ROUTE 30",
            "address_2": "SUITE 25",
            "city": "NORTH HUNTINGDON",
            "state": "PA",
            "postal_code": "156422595",
            "telephone_number": "724-382-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLENS",
        "first_name": "PRESTON",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-03",
        "last_updated": "2013-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Huntingdon, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.