Active NPI
Merodie Erin Mullis, PHYSICAL THERAPIST
- Physical Therapist
- Cupertino, CA
National Provider Identifier
1891848685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 11975
- Practice address
- 10080 N Wolfe Rd
SW3-100
Cupertino, CA 95014-2515 - Phone
- (408) 342-6637
- NPI assigned
- Jan 18, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 11975 | CA | Primary |
Addresses
Primary practice location
10080 N Wolfe Rd
SW3-100
Cupertino, CA 95014-2515
Mailing address
10080 N Wolfe Rd
SW3 - 100
Cupertino, CA 95014-2515
Phone (408) 342-6600
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 11975 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Hospitals | Past | Accepting new patients |
Organizations & group practices 1
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.
-
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- Lancaster, CA
- NPI 1851169965
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891848685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10080 N WOLFE RD",
"address_2": "SW3 - 100",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950142515",
"telephone_number": "408-342-6600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10080 N WOLFE RD",
"address_2": "SW3-100",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950142515",
"telephone_number": "408-342-6637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLIS",
"first_name": "MERODIE",
"middle_name": "ERIN",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 11975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.