Jerry Mullis, MD is a medicare enrolled "Emergency Medicine" physician in Jesup, Georgia. His current practice location is
865 S 1st St, Jesup, Georgia. You can reach out to his office (for appointments etc.) via phone at
(904) 805-1300.
Jerry Mullis is licensed to practice in Georgia (license number 42368) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851314975.
Physician's Profile
| Full Name | Jerry Mullis |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 865 S 1st St, Jesup, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1851314975
- Provider Enumeration Date: 07/26/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8820996564
- Enrollment ID: I20040408000753
Medical Identifiers
Medical identifiers for Jerry Mullis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851314975 | NPI | - | NPPES |
| 100165 | Other | GA | BLUE CROSS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 42368 (Georgia) | 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. Jerry Mullis allows following entities to bill medicare on his behalf.
| Entity Name | Paragon Emergency Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912101650
PECOS PAC ID: 8628153087
Enrollment ID: O20080310000143 |
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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. Jerry 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 |
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Jerry Mullis, MD
Po Box 532855,
Atlanta, GA 30353-2855
Ph: (904) 805-1300 | Jerry Mullis, MD
865 S 1st St,
Jesup, GA 31545-0210
Ph: (904) 805-1300 |
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