Active NPI
Elizabeth Reid Mullett, OD
- Optometrist
- Greenville, NC
National Provider Identifier
1831182252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1503
- Practice address
- 2573 Stantonsburg Rd
Greenville, NC 27834-7213 - Phone
- (258) 275-8210
- Fax
- (252) 758-2103
- NPI assigned
- Aug 31, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1503 | NC | Primary |
Addresses
Primary practice location
2573 Stantonsburg Rd
Greenville, NC 27834-7213
Mailing address
2573 Stantonsburg Rd
Greenville, NC 27834-7213
Phone (258) 275-8210
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8909653 | Medicaid | NC | |
| 5344860001 | Other | NC | CIGNA/DMERC PROVIDER ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1503 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278892800000",
"number": "1831182252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2573 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278347213",
"telephone_number": "258-275-8210",
"fax_number": "252-758-2103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2573 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278347213",
"telephone_number": "258-275-8210",
"fax_number": "252-758-2103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLETT",
"first_name": "ELIZABETH",
"middle_name": "REID",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-31",
"last_updated": "2010-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8909653",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA/DMERC PROVIDER ID",
"identifier": "5344860001",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.