Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Ally Shae Mullins

Individual provider Physician Assistant · NPI 1114762168

Mrs. Ally Shae Mullins is a Physician Assistant in Jackson, Mississippi. Qualified in 2025, 1 year ago. Practices with State of Mississippi - University of Mississippi Medical Center, a 952-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
1
Licensed in
MS
In the registry since
2024
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2500 N State St
Jackson, MS 39216-4500
Phone: (601) 984-1000
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00884 (MS)

Record details

NPI number1114762168
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 29, 2024
Last updated in NPPESMarch 10, 2025
Certification dateFebruary 14, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice State Of Mississippi - University Of Mississippi Medical Center — 952 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Jackson