Individual provider Active NPI

Craig Mullen, CRNP

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1891347761
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R221065 Issued in MD
Practice address
5663 Kirkpatrick CT
Salisbury, MD 21801-2374
Phone
(302) 500-3955
NPI assigned
Jul 11, 2019
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R221065 MD Primary

Addresses

Primary practice location

5663 Kirkpatrick CT
Salisbury, MD 21801-2374

Mailing address

436 Rolling Rd
Salisbury, MD 21801-7115

Other practice location 1

436 Rolling Rd
Salisbury, MD 21801-7115
Phone (302) 542-6034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000483 MD Practitioner - Nurse Practitioner 2567890866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Atlantic IncGroup PAC ID 2365437837, 95 clinicians

Practice addresses (Care Compare)

6040 Public Landing Rd
Snow Hill, MD 21863-2453
Phone (410) 629-0041

9714 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 641-3340

9733 Healthway Dr
Berlin, MD 21811-1155
Phone (410) 641-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
70.92
Promoting interoperability
98
Improvement activities
40
Cost
71.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R221065MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Atlantic, Inc. CurrentSince Dec 4, 2019 Accepting new patients
Atlantic General Hospital Corporation CurrentSince Dec 4, 2019 Accepting new patients
Tidalhealth Atlantic, Inc Past Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients

Locations

10026 Old Ocean City Blvd
Ste 1
Berlin, MD 21811

9714 Healthway Dr
Berlin, MD 21811
Phone (410) 641-2600

6040 Public Landing Rd
Snow Hill, MD 21863
Phone (410) 629-0041

Interoperability endpoints

  • Direct secure messaging: craigmullen@agh.allscriptsdirect.net

Organizations & group practices 4

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 1

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1891347761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 ROLLING RD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5663 KIRKPATRICK CT",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012374",
            "telephone_number": "302-500-3955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "436 Rolling Rd",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218017115",
            "country_code": "US",
            "telephone_number": "302-542-6034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R221065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.