Mallory Boyette

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN234868 Issued in GA

Practice address

5354 Reynolds Street
Professional Building Suite 318
Savannah, GA 31405

Phone

(912) 819-4870

NPI assigned

Jun 25, 2019

Last updated

Apr 22, 2024By the provider in NPPES

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 GA

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Complexcare Medical Group Southeast H PLLCGroup PAC ID 9830693993, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Complexcare Medical Group Southeast H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1083508238

  GA

  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  GA

  Medicare reassignment Care Compare group NPD
• Complexcare Medical Group Midwest M PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1528851607
  NPD (past)

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1013578640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS STREET",
            "address_2": "PROFESSIONAL BUILDING SUITE 318",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 REYNOLDS STREET",
            "address_2": "PROFESSIONAL BUILDING SUITE 318",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYETTE",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN234868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Rozeboom Bowling
• Buffi G Boyd, M.D.
• Carl Richard Boyd, M.D.
• Jennifer Boyd
• Megan Boyd, FNP-C
• Maryjo Boyles, LPN
• Lisa A Bozik, MD
• Mikayla C Brabham
• Brittaney Brackett, LCSW
• Cheryl Ann Brackin, M.ED., CCC-SLP

• Family Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.