Mallory V Peden, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

PT3794 Issued in MS

Practice address

960 Commonwealth Blvd
Tupelo, MS 38804-9762

Phone

(662) 260-3789

Fax

(662) 260-3790

NPI assigned

Jul 20, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Saltillo, MS
  • NPI 1386010718
  Medicare reassignment NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Louisville, MS
  • NPI 1952732448

  Occupational Therapist

  Medicare reassignment NPD
• Peden Pediatric Therapy, LLC

  • Occupational Therapist
  • Ecru, MS
  • NPI 1407632474
  NPD Authorized official
• Dpti Elite Physical Therapy LLC

  • Physical Therapist
  • Baldwyn, MS
  • NPI 1013383496

  Occupational Therapist

  NPD
• Drayer Physical Therapy Mississippi LLC

  • Physical Therapist
  • Crystal Springs, MS
  • NPI 1801333521
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1003424748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8205 PRESIDENTS DR",
            "city": "HUMMELSTOWN",
            "state": "PA",
            "postal_code": "170368621",
            "telephone_number": "717-839-2188",
            "fax_number": "717-565-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 COMMONWEALTH BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049762",
            "telephone_number": "662-260-3789",
            "fax_number": "662-260-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDEN",
        "first_name": "MALLORY",
        "middle_name": "V",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "PT3794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parvesh Paul, MBBS, MD
• Pax House Counseling and Play Therapy LLC
• Katherine Payne
• Ani Pazhava, MD
• Gregory Peacock
• Pediatrix Medical Group of Mississippi, Inc.
• Erica L Peebles
• Jeannie D Pence, CANP
• Annalyn Penkala, DO
• Shonterria Penson

• Occupational Therapist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.