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J MULLALLY MD PLLC
NPI 1699084889
Family Medicine in Port Huron, MI

Active since October 05, 2010CLIA 23D0992827 · Microscopy
1117 STONE ST, SUITE 2, PORT HURON, MI 48060(810) 966-4540 Get Directions Write a Review

NPPES record last updated: October 5, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About J Mullally Md Pllc NPPES

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

J MULLALLY MD PLLC (NPI 1699084889) is a healthcare organization registered as a family medicine in Port Huron, Michigan and active in the NPI registry since October 2010. The organization holds a CLIA Microscopy certificate valid through October 25, 2027 and lists Beth A Noble, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1699084889
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJ MULLALLY MD PLLC
Location Address1117 STONE ST, SUITE 2Port Huron, MI 48060-3525
Mailing Address1117 Stone St, Suite 2Port Huron, MI 48060-3525 · (810) 966-4540
Phone(810) 966-4540
Organization SubpartNo
Authorized OfficialBeth A NobleOffice Manager · (810) 966-4540
Enumeration DateOctober 5, 2010
✔ NPI 1699084889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1117 STONE ST, Port Huron, MI 48060
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D0992827

J Mullally MD PLLC · Port Huron, MI
Active · expires Oct 25, 2027
CLIA Number23D0992827
Laboratory TypePhysician Office
Certificate Effective DateOctober 26, 2025
Certificate Expiration DateOctober 25, 2027
Laboratory DirectorJohn P. Mullally
Laboratory Phone(810) 966-4540
Laboratory LocationJ Mullally MD PLLC1117 Stone Street Suite 2, Port Huron, MI 48060
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

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

DR. JOHN PATRICK MULLALLY MD
Family Medicine
1117 STONE ST, SUITE 2
PORT HURON, MI 48060
St. Clair County (810) 966-4540
MRS. KIMBERLY ANN KORNIECK M.T.
Massage Therapist
1117 STONE ST, SUITE 4
PORT HURON, MI 48060
St. Clair County (810) 941-4256
DR. DEMIAN IBRAHIM NAGUIB M.D.
Psychiatry & Neurology (Neurology)
1117 STONE ST, SUITE 1
PORT HURON, MI 48060
St. Clair County (810) 985-9699
NEUROLOGY AND SLEEP CARE, PLLC
Psychiatry & Neurology (Pain Medicine)
1117 STONE ST, SUITE 1
PORT HURON, MI 48060
St. Clair County (810) 985-9699
ST. CLAIR CARDIOVASCULAR SURGEONS, PLC
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1117 STONE ST, SUITE 1
PORT HURON, MI 48060
St. Clair County (810) 987-3558

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is J Mullally MD PLLC's NPI number?

The NPI number for J Mullally MD PLLC is 1699084889. It was assigned to this organization in the NPPES registry on October 5, 2010.

Where is J Mullally MD PLLC located?

J Mullally MD PLLC is located at 1117 Stone St Suite 2, Port Huron, MI 48060. The listed phone number is (810) 966-4540.

What is J Mullally MD PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does J Mullally MD PLLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0992827) is associated with this NPI, valid through October 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does J Mullally MD PLLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Cross Blue Shield of Michigan Mutual Insurance Company list J Mullally MD PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for J Mullally MD PLLC was last updated on October 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years 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.