Individual provider Active NPI

Jeffrey C. Mull, M.D.

  • Emergency Medicine Physician
  • Corvallis, OR
National Provider Identifier
1902833767
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD13544 Issued in OR
Practice address
Oregon State University Student Health Services
Plageman 201
Corvallis, OR 97331
Phone
(541) 737-3106
Fax
(541) 737-4530
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD13544 OR Primary

Addresses

Primary practice location

Oregon State University Student Health Services
Plageman 201
Corvallis, OR 97331

Mailing address

6607 SW Winding Way
Corvallis, OR 97333-2608
Phone (541) 929-4440

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20040401000883 OR Practitioner - Emergency Medicine 5597757252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health West Valley CurrentSince Jul 8, 2022 Accepting new patients
Salem Health Current Accepting new patients
Good Samaritan Hospital Corvallis Past Accepting new patients
Firstcare Medical Foundation Emergency Medicine PastSince Sep 1, 2004 Accepting new patients
Salem Emergency Physicians Service, PC Emergency Medicine PastSince Jul 1, 2008 Accepting new patients

Locations

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

512 Main St E
Ste 300
Monmouth, OR 97361
Phone (503) 838-1182

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Bldg A
Salem, OR 97301
Phone (503) 370-5634

1002 Bellevue St SE
Salem, OR 97301
Phone (503) 561-5554

Interoperability endpoints

  • Direct secure messaging: jmull19757@direct.salemhealth.org

Organizations & group practices 5

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902833767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6607 SW WINDING WAY",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973332608",
            "telephone_number": "541-929-4440",
            "fax_number": "541-737-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OREGON STATE UNIVERSITY STUDENT HEALTH SERVICES",
            "address_2": "PLAGEMAN 201",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "97331",
            "telephone_number": "541-737-3106",
            "fax_number": "541-737-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULL",
        "first_name": "JEFFREY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD13544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.