Mark J Malley, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

36717 Issued in MO

Practice address

630 NW Englewood Rd
Kansas City, MO 64118-3973

Phone

(816) 453-2700

Fax

(816) 453-9943

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1003819947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 NW ENGLEWOOD RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641183973",
            "telephone_number": "816-453-2700",
            "fax_number": "816-453-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 NW ENGLEWOOD RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641183973",
            "telephone_number": "816-453-2700",
            "fax_number": "816-453-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLEY",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "36717",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-22685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Lynn Mall, L.AC.
• Leslie Marie Malle, APRN
• Kathleen Mallett, MSN, FNP-C
• Raquel Desiree Mallett
• Luellen Malley, M.D.
• Logan A Mallicoat, DDS
• Alexander G. Mallouk, M.D.
• Lindsey Elizabeth Malloy-Walton, D.O.
• Jennifer Malloy
• Heather Jean Malone, MD

• Diagnostic Radiology Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.