MRS. ALLY SHAE MULLINS
NPI 1114762168
Physician Assistant in Jackson, MS

Q: What is Ally Mullins's NPI number?

The NPI number for Ally Mullins is 1114762168. It was assigned to this individual provider in the NPPES registry on June 29, 2024.

Q: What is Ally Mullins's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Ally Mullins was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 29, 2024PECOS EnrolledAccepts Medicare Assignment

2500 N STATE ST, JACKSON, MS 39216(601) 984-1000 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 10, 2025, Jun 29, 2024 (2 updates tracked since 2024).

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About Mrs. Ally Shae Mullins NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ALLY SHAE MULLINS (NPI 1114762168) is an individual physician assistant in Jackson, Mississippi, licensed in Mississippi (PA00884) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with University Of Mississippi Med Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1114762168

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. ALLY SHAE MULLINS

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address110 Hampton PlMadison, MS 39110-4575 · (352) 672-5175

Phone(601) 984-1000

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateJune 29, 2024

Last NPPES UpdateMarch 10, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 14, 2025

✔ NPI 1114762168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MS · PA00884

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2500 N STATE ST, Jackson, MS 39216

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Ally Shae Mullins is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840719431

PECOS Enrollment IDI20250528000036

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Mississippi Med Center

Acute Care Hospitals · Jackson, MS

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number250001

Location2500 N State StJackson, MS 39216 · Hinds County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39216 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)