Mallory B Hommertzheim, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1257 Issued in CO

Practice address

595 Chapel Hills Dr Ste 303B
Colorado Springs, CO 80920-1022

Phone

(719) 922-1002

Fax

(719) 888-1841

NPI assigned

Oct 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mallory B Martin Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

University of South Alabama College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MWS Wound Solutions LLCGroup PAC ID 2567801541, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26269/brand/1/csg/1/fhir/r4
• Direct secure messaging: mallory.martin.1@26269.direct.athenahealth.com

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.

• MWS Wound Solutions LLC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1184482952
  Medicare reassignment Care Compare group NPD
• Lykos Medical LLC

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1215423124
  Medicare reassignment NPD

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1073154787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR STE 303B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201022",
            "telephone_number": "719-922-1002",
            "fax_number": "719-888-1841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 CHAPEL HILLS DR STE 303B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201022",
            "telephone_number": "719-922-1002",
            "fax_number": "719-888-1841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMMERTZHEIM",
        "first_name": "MALLORY",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "113578",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "1257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MARTIN",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Homeward Pikes Peak
• Homeward Pikes Peak
• Homeward Pikes Peak
• Homeward Pikes Peak
• Kara Dinda Hommerding, PA-C
• Fletcher Honea
• Abby Honeycutt
• Lauren Lea Hood, PMHNP-BC
• Mackenzie Anne Hood, DENTAL ASSISTANT
• Whitney Hood

• Family Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.