Matthew W McMullen, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0102210187 Issued in VA

Practice address

310 Old Ivy Way Ste 104
Charlottesville, VA 22903-4896

Phone

(434) 358-9090

Fax

(434) 243-6970

NPI assigned

Apr 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Psychiatry

Education

Campbell Univ School of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1982285615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 OLD IVY WAY STE 104",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229034896",
            "telephone_number": "434-358-9090",
            "fax_number": "434-243-6970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0102210187",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102210187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Jean McMahon, PHARMD
• Kathleen A. McManus, M.D.
• Lindsay Gray Zano McMillan, M.ED
• Meaghan McMillen, ATC
• Shorn D McMoore, DDS
• Carolyn McMullin, FNP
• Marianna N McMurray, PT
• Gabriel McNabb
• Michelle Wagner McNally
• Coleen A. McNamara, M.D.

• Child & Adolescent Psychiatry Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Child & Adolescent Psychiatry Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.