MR. PATRICK JAMES MULLEN (NPI# 1629069885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629069885 |
| Entity Type | Individual |
| Full Name | MR. PATRICK JAMES MULLEN |
| Credential | M.D. |
| Practice Address |
2121 W Ironwood Center Dr Coeur D Alene ID 83814-2639 |
| Mailing Address |
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 |
| Practice Telephone | 2086254680 |
| Practice Fax Number | 2086254681 |
| Mailing Telephone | 2086255085 |
| Mailing Fax Number | 2086255731 |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2020-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
M8506 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806468700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053611632 | Patrick Thomas Mullen | Driver | 4921 Haven Ave, Ocean City, NJ 08226-1458 | 2010-10-28 |
| 1871721233 | Patrick Richard Mullen | Social Worker | 3108 58th Ave N, Saint Petersburg, FL 33714-1331 | 2009-06-24 |
| 1740378157 | Patrick Bowman Mullen | Psychiatry & Neurology | 3c Cleveland Court, Greenville, SC 29607 | 2006-10-11 |
| 1831153865 | Patrick Dennis Mullen | Specialist | 216 N Bickett Blvd, Suite 5, Louisburg, NC 27549-2473 | 2006-04-14 |
| 1871150284 | Patrick John Mullen | Podiatrist | 2139 Auburn Ave, Cincinnati, OH 45219-2906 | 2019-05-21 |
| 1487117115 | Patrick Sweeney Mullen | Student in an Organized Health Care Education/Training Program | 590 Manning Dr # 7595, Chapel Hill, NC 27599-6119 | 2019-04-10 |
| 1154796092 | Patrick Mullen | Social Worker | 400 Johnson St, Alpena, MI 49707-1434 | 2015-12-03 |
| 1760520126 | Patrick James Mullen | Physician Assistant | 9002 Queens Blvd, Elmhurst, NY 11373-4941 | 2007-02-01 |
| 1194838573 | Patrick William Mullen | Podiatrist | 6335 N Fresno St, #208, Fresno, CA 93710-5272 | 2006-08-17 |
| Street Address |
2121 W IRONWOOD CENTER DR |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003050527 | Peter C Jones Md Pa | Specialist | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2009-04-28 |
| 1841430063 | Shannon Marie Jahns | Specialist/Technologist, Other | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2009-02-27 |
| 1083704332 | Peter Christopher Jones | Plastic Surgery | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2006-10-14 |
| 1609966951 | Coeur D'alene Surgery Center Inc | Clinic/Center | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2006-10-14 |
| 1114992179 | James W Dutkiewicz | Physician Assistant | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2006-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1588877641 | John Arthur Jarrell Iv | Surgery | 3090 E Gentry Way Ste 210, Meridian, ID 83642-3550 | 2007-05-07 |
| 1265656268 | David William Becker Jr. | Surgery | 668 Ballingrude Dr, Twin Falls, ID 83301-4403 | 2007-04-12 |
| 1912046210 | Center for Aesthetics PC | Surgery | 2375 E Sunnyside Road, Suite G, Idaho Falls, ID 83404 | 2007-02-05 |
| 1073668042 | Thomas Floyd Crais Jr. | Surgery | 315 S River St, Hailey, ID 83333-8426 | 2007-01-23 |
| 1003823956 | Craig B. Bass | Surgery | 250 Bobwhite Ct, # 275, Boise, ID 83706-6643 | 2006-08-02 |
| 1427086164 | Mark David Wigod | Surgery | 3630 E Louise Drive, Meridian, ID 83642 | 2006-06-29 |
| 1477195931 | Jarrell Plastic Surgery | Surgery | 3090 E Gentry Way Ste 210, Meridian, ID 83642-3550 | 2019-10-16 |
| 1720381536 | Patrick J Mullen Md Pllc | Surgery | 750 N Syringa St, Suite 204, Post Falls, ID 83854-5275 | 2010-12-16 |
| 1073757464 | Michael R Dibenedetto Md Pllc | Surgery | 30544 Highway 200, Suite 102, Ponderay, ID 83852-5005 | 2009-04-29 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.