Baron T Mullis, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME113789 Issued in FL

Practice address

307 Boatner Road, Suite 114
Emergency Medicine Dept
Eglin Afb, FL 32542

Phone

(850) 883-8227

Fax

(850) 883-8133

NPI assigned

Jul 2, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: bmullis2018601@direct.trinity-health.org

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.

• Floridian Emergency Specialists LLC

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1710210695
  Medicare reassignment NPD
• Athens Clarke Medical Enterprises LLC

  • Emergency Medicine Physician
  • Athens, GA
  • NPI 1295370542
  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment NPD
• Floridian Emergency Specialists, LLC

  • Emergency Medicine Physician
  • Crestview, FL
  • NPI 1992150007
  NPD
• Santa Rosa HB Medical Services LLC

  • Emergency Medicine Physician
  • Milton, FL
  • NPI 1982384988
  NPD
• Athens Clarke Medical Enterprises LLC

  • Emergency Medicine Physician
  • Greensboro, GA
  • NPI 1538791579
  NPD
• Blue Job Emergency Physicians LLC

  • Emergency Medicine Physician
  • Fort Walton Beach, FL
  • NPI 1457760142
  NPD (past)
• Madison Emergency Group, PC

  • Emergency Medicine Physician
  • Madison, GA
  • NPI 1770193419
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1922237676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER ROAD, SUITE 114",
            "address_2": "EMERGENCY MEDICINE DEPT",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "32542",
            "telephone_number": "850-883-8227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER ROAD, SUITE 114",
            "address_2": "EMERGENCY MEDICINE DEPT",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "32542",
            "telephone_number": "850-883-8227",
            "fax_number": "850-883-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "BARON",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-02",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "LL31970",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME113789",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "75051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Morin
• Elissa B Morrow, LCSW
• Lydia Ann Moss
• Michael Nicholas Moulton, DO
• Toni Lee Mowrer
• Tylan Muncy, MD
• Nicholas J Myers, M.D.
• Trichinopoly Ramaswamy Narayanaswamy, MD
• Joshua Nardone, DDS, MS
• National Vision, Inc.

• Emergency Medicine Physician in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.