NPIMap

Individual provider Active NPI

Mallory Richert, PSYD

  • Clinical Neuropsychologist
  • Louisville, KY
National Provider Identifier
1003608324
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
295748 Issued in KY
Practice address
220 Abraham Flexner Way
Louisville, KY 40202-3826
Phone
(502) 582-7484
NPI assigned
May 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 295748 KY Primary

Addresses

Primary practice location

220 Abraham Flexner Way
Louisville, KY 40202-3826

Mailing address

2375 Sir Barton Way Apt 2312
Lexington, KY 40509-2568
Phone (402) 480-0216

Other practice location 1

2375 Sir Barton Way Apt 2312
Lexington, KY 40509-2568
Phone (402) 480-0216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623001061 KY Practitioner - Clinical Psychologist 9234641622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

220 Abraham Flexner Way
Louisville, KY 40202-3826

571 S Floyd St
Louisville, KY 40202-3818
Phone (502) 629-2398

Hospital & facility affiliations

  • Frazier Rehab Institute Inpatient rehabilitation facility, Louisville, KY, CCN 18T040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
295748KYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 9, 2025 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jun 9, 2025 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

220 Abraham Flexner Way
Louisville, KY 40202
Phone (502) 582-7400

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 3

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1003608324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 SIR BARTON WAY APT 2312",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092568",
            "telephone_number": "402-480-0216",
            "fax_number": "402-480-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ABRAHAM FLEXNER WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023826",
            "telephone_number": "502-582-7484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2375 Sir Barton Way Apt 2312",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092568",
            "country_code": "US",
            "telephone_number": "402-480-0216",
            "fax_number": "402-480-0216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHERT",
        "first_name": "MALLORY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "295748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.