DR. ALEXEA MULLIS (AU.D) – Audiologist, NPI 1417785023

DR. ALEXEA MULLIS (AU.D) is a healthcare provider. based in Fayetteville, Georgia. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials AU.D. They hold a License No. AUD004405 (GA). The NPI Number for DR. ALEXEA MULLIS (AU.D) is 1417785023

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
DR. ALEXEA MULLIS (AU.D)
NPI
1417785023
Phone
(770) 631-1833
Address
1260 HIGHWAY 54 W STE 203
Enumeration Date
24 July 2024
Last Update Date
24 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7706311833
Graduation Year
2024 (2 years ago)
PAC ID
3971038597
Group Practice PAC ID
6002800570
Professional Enrollment ID
I20241209000354
Address ID
GA302144513FA1260XWXXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

263 QUALIFIED AUDIOLOGIST in GA

Provider Addresses for DR. ALEXEA MULLIS (AU.D)

  • 1260 HIGHWAY 54 W STE 203

    FAYETTEVILLE, GA 302144513

    Phone: (770) 631-1833

    Type: Mailing

  • 1260 HIGHWAY 54 WEST

    SUITE 203

    FAYETTEVILLE, GA 30214

    Phone: (770) 631-1833

    Fax: (770) 461-9402

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241209000354IQualified AudiologistGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30214)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002800570View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. ALEXEA MULLIS (AU.D) using NPI 1417785023?
NPI 1417785023 belongs to DR. ALEXEA MULLIS (AU.D); compare other details if you need extra assurance.
Is DR. ALEXEA MULLIS (AU.D) still an active registrant?
DR. ALEXEA MULLIS (AU.D) carries an active NPI according to the public dataset.
What area of care is associated with DR. ALEXEA MULLIS (AU.D)?
DR. ALEXEA MULLIS (AU.D)'s record emphasizes Audiologist. Clinical services aligned with this taxonomy classification.
Where in Georgia is DR. ALEXEA MULLIS (AU.D) registered?
Use Fayetteville, Georgia as the headline location for DR. ALEXEA MULLIS (AU.D) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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