Active NPI
Jeremy D Mullins, M.S. R.D.
- Registered Dietitian
- Charleston, WV
National Provider Identifier
1912109042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- Medabolix Inc 600 Tracy Way
Suite 200
Charleston, WV 25311 - Phone
- (304) 347-4313
- Fax
- (304) 347-4316
- NPI assigned
- Jun 1, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | WV | Primary |
Addresses
Primary practice location
Medabolix Inc 600 Tracy Way
Suite 200
Charleston, WV 25311
Mailing address
101 29TH St SE
Unit 15
Charleston, WV 25304-1149
Phone (304) 347-4313
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medabolix, Inc. | Dietitian, Registered | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912109042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 29TH ST SE",
"address_2": "UNIT 15",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041149",
"telephone_number": "304-347-4313",
"fax_number": "304-347-4316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDABOLIX INC 600 TRACY WAY",
"address_2": "SUITE 200",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25311",
"telephone_number": "304-347-4313",
"fax_number": "304-347-4316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLINS",
"first_name": "JEREMY",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "M.S. R.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "WV",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
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.