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Deactivated NPI 1396964557 Deactivated / Inactive NPI Male Practitioner

Jerry Daniel Mullin , OTR

Skilled Nursing Facility • Mt. Ida, AR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jerry Mullin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 25, 2007
NPI Deactivation Date January 28, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Jerry Mullin, OTR was a registered Skilled Nursing Facility practicing in Mt. Ida, AR. Throughout an active medical career spanning 15 years, Jerry Mullin provided care at the practice location at 741 SOUTH DRIVE until profile deactivation on 2022-01-28.

Practice Location & Contact Primary Location

Practice Address

741 South Drive

Mt. Ida, AR 71957

Telephone 8708672156
Fax 8708672584
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Skilled Nursing Facility in Mt. Ida, AR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Mt. Ida, AR (6 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Skilled Nursing Facility Primary Specialty

NUCC Taxonomy Code: 314000000X

State License AR 196

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Billie Jones , CF-SLP

Speech-Language Pathologist

NPI 1053510537

Clinical Fellow in Speech-Language Pathology

Kathleen Peters , OTR

Occupational Therapist

NPI 1477908325

Occupational Therapist Registered

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 28, 2022

Record deactivated on January 28, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 741 SOUTH DRIVE, MT. IDA, AR 71957 (Tel: 8708672156)

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Updated Business Mailing Address July 08, 2007

Registered at 2595 HIGHWAY 270 E, MOUNT IDA, AR 719578066 (Tel: 8708674625)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JERRY MULLIN, OTR

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Skilled Nursing Facility (License #196 in AR)

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Initial NPI Registration & Enumeration April 25, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396964557
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2007
Last Update: July 08, 2007
Deactivation Date: January 28, 2022

Mailing Address

2595 Highway 270 E

Mount Ida, AR 719578066

Phone: 8708674625

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.