Dr Kiersten P Mullis, DO is a medicare enrolled "Family Medicine" physician in Yanceville, North Carolina. Her current practice location is
439 Us Hwy 158 West, Yanceville, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 694-9331.
Dr Kiersten P Mullis is licensed to practice in North Carolina (license number 2021-02336) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639632391.
Physician's Profile
Full Name | Dr Kiersten P Mullis |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 439 Us Hwy 158 West, Yanceville, North Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1639632391
- Provider Enumeration Date: 04/10/2019
- Last Update Date: 06/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 2860874740
- Enrollment ID: I20220809003168
Medical Identifiers
Medical identifiers for Dr Kiersten P Mullis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639632391 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 250906 (North Carolina) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | 2021-02336 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kiersten P Mullis allows following entities to bill medicare on her behalf.
Entity Name | Compassion Health Care Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134201387 PECOS PAC ID: 4082602388 Enrollment ID: O20040626000325 |
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Entity Name | Moses Cone Physician Services, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093953127 PECOS PAC ID: 4284782210 Enrollment ID: O20090501000202 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kiersten P Mullis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Kiersten P Mullis, DO 1125 N Church St, Greensboro, NC 27401-1007 Ph: () - | Dr Kiersten P Mullis, DO 439 Us Hwy 158 West, Yanceville, NC 27379-1007 Ph: (336) 694-9331 |
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