Mallory Smith, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26148 Issued in SC

Practice address

420 Polifka Dr
Shaw Afb, SC 29152-5100

Phone

(803) 895-2273

NPI assigned

Oct 26, 2022

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tandem Health SCGroup PAC ID 3870575855, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1386630192

  SC

  Medicare reassignment Care Compare group NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Pinewood, SC
  • NPI 1811973068
  Care Compare group NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1821885583
  Care Compare group NPD
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1356772776
  Care Compare group
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Rembert, SC
  • NPI 1588437438
  Care Compare group
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1649035841
  Care Compare group
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Pinewood, SC
  • NPI 1689447534
  Care Compare group
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1720875487
  Care Compare group
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1740641919
  Care Compare group
• Tandem Health SC

  • Federally Qualified Health Center (FQHC)
  • Sumter, SC
  • NPI 1821887480
  Care Compare group

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1003533357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 POLIFKA DR",
            "city": "SHAW AFB",
            "state": "SC",
            "postal_code": "291525100",
            "telephone_number": "803-895-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "26148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A. Schievenin, M.D.
• Christopher Schreiner
• Victoria Sefcsik-Revelle, DO
• Kimberly Marie Shanks, FNP
• Rebecca Sarah Slogic, M.D.
• Melissa Ann Smith, MS, ATC
• Nathan Augustine Sollenberger, PHD
• Jessica Lauren Starnes, DMD
• Veronica Levette Stukes, APRN
• Ericniesha Taylor, LCSW-C, LICSW

• All providers in Shaw Afb, SC
• Primary Care Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.