Individual provider Active NPI

Mallory Kendal Otto-Brown, CNM

  • Advanced Practice Midwife
  • Denver, CO
National Provider Identifier
1063186146
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
4545 E 9TH Ave Ste 502
Denver, CO 80220-3910
Phone
(303) 320-2944
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X APN.0996501-CNM CO
Advanced Practice Midwife 367A00000X Primary

Addresses

Primary practice location

4545 E 9TH Ave Ste 502
Denver, CO 80220-3910

Mailing address

12303 Airport Way Ste 140
Broomfield, CO 80021-2728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019001925 CO Practitioner - Certified Nurse Midwife (CNM) 7012305345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthone Clinic Services - Obstetrics and Gynecology LLCGroup PAC ID 4587759972, 62 clinicians

Practice addresses (Care Compare)

1400 S Potomac St
Suite 225
Aurora, CO 80012-4514
Phone (303) 873-5245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APN.0996501-CNMCOMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Healthone Clinic Services - Obstetrics and Gynecology LLC Advanced Practice Midwife CurrentSince Jul 11, 2023 Accepting new patients
HCA Healthone LLC Past Accepting new patients
Healthone Clinic Services LLC Past Accepting new patients

Locations

4545 E 9th Ave
Ste 502
Denver, CO 80220
Phone (303) 320-2944

1400 S Potomac St
Ste 225
Denver, CO 80012
Phone (303) 563-2782

9195 Grant St
Ste 410
Thornton, CO 80229
Phone (303) 280-2229

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: mallory.otto@hca3.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1063186146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 AIRPORT WAY STE 140",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E 9TH AVE STE 502",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802203910",
            "telephone_number": "303-320-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO-BROWN",
        "first_name": "MALLORY",
        "middle_name": "KENDAL",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CO",
            "license": "APN.0996501-CNM",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.