Mallory Tobon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.1168 Issued in AL

Practice address

210 Greeno Rd N
Fairhope, AL 36532-2914

Phone

(251) 277-5300

NPI assigned

Sep 23, 2016

Last updated

Mar 31, 2026By 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

Other names 1

• Mallory Mullis Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Services of the Gulf Coast LLCGroup PAC ID 8426301607, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Physician Services of the Gulf Coast LLC

  dba AlphaCare Urgent Care

  • Urgent Care Clinic/Center
  • Biloxi, MS
  • NPI 1366922023

  AL

  Medicare reassignment Care Compare group NPD (past)

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1073062782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 CEDAR LAKE RD STE E",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395322126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GREENO RD N",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322914",
            "telephone_number": "251-277-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10719 Eastern Shore Blvd",
            "address_purpose": "LOCATION",
            "city": "Spanish Fort",
            "state": "AL",
            "postal_code": "365276042",
            "country_code": "US",
            "telephone_number": "251-270-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOBON",
        "first_name": "MALLORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MULLIS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel G Thompson, PA-C
• Ellen Scott Thomson, RN, BSN, IBCLC
• Remonica Thurmond, PMHNP-BC
• Anna Reid Tindle, CRNP
• Timothy Tisdale, PA-C
• Melissa McCraney Tompkins, NP-C
• Hanson C Ton, MD
• Suzanne Tormoen, M.D.
• Sebastian Antonio Torres, DMD
• David Thornton Trice, MD

• Physician Assistant in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.