Active NPI
Karen B Mulloy, DO
- Family Medicine Physician
- Cleveland, OH
National Provider Identifier
1922172659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34.010733
- Practice address
- 11100 Euclid Ave
Department of Family Medicine
Cleveland, OH 44106-1716 - Phone
- (216) 368-5967
- Fax
- (216) 368-3194
- NPI assigned
- Nov 17, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | A-1009 94 | NM | |
| Family Medicine Physician | 207Q00000X | 34.010733 | OH | Primary |
| Occupational Medicine Physician | 2083X0100X | 34.010733 | OH |
Addresses
Primary practice location
11100 Euclid Ave
Department of Family Medicine
Cleveland, OH 44106-1716
Mailing address
24701 Euclid Ave
3Rd Floor
Euclid, OH 44117-1714
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50559 | Medicaid | NM | |
| 34.010733 | Other | OH | LICENSE |
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-1009 94 | NM | MD | Occupational Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1922172659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24701 EUCLID AVE",
"address_2": "3RD FLOOR",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11100 EUCLID AVE",
"address_2": "DEPARTMENT OF FAMILY MEDICINE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061716",
"telephone_number": "216-368-5967",
"fax_number": "216-368-3194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLOY",
"first_name": "KAREN",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "NM",
"license": "A-1009 94",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34.010733",
"primary": true
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "OH",
"license": "34.010733",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "50559",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "34.010733",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.