Jerry Mullis, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

42368 Issued in GA

Practice address

2100 Riverside Ave
Waycross, GA 31501-7020

Phone

(912) 490-7777

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Faith Family Practice LLC

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1649819343
  Medicare reassignment NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment NPD
• Jesup Emergency Services, LLC

  • Emergency Medicine Physician
  • Jesup, GA
  • NPI 1699733832
  NPD (past)
• Belfort Emergency Physicians

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1912195108
  NPD (past)
• Florida Em-I Medical Services PA

  • Emergency Medicine Physician
  • St Petersburg, FL
  • NPI 1386693273
  NPD (past)
• Quality Primary Care P a

  • Primary Care Clinic/Center
  • Jacksonville, FL
  • NPI 1245525518
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1851314975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532855",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303532855",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 RIVERSIDE AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315017020",
            "telephone_number": "912-490-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "865 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315450210",
            "country_code": "US",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "JERRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "42368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000754872D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000754872H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "100165",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James C. Morton Jr., DDS
• Lindsey Kaitlyn Morton
• William Alan Morton, M.D.
• Vanessa Vershel Moseley, NP
• Daniel Mulder, OD
• Tera Nicole Murchinson, LPC
• David P Murphy, D.P.M.
• Jeannie Thompson Murray, LCSW
• Megan Nicole Music
• Kaylee Davis Musselwhite, PT, DPT

• Emergency Medicine Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.