Mallory N Blassingham, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.028112 Issued in IL

Practice address

209 N Union St
Byron, IL 61010-8626

Phone

(815) 234-5553

Fax

(815) 234-5557

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 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

Other names 1

• Mallory N Schilf Former name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ortho Rehab Specialists PLLCGroup PAC ID 8527492354, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Ortho Rehab Specialists PLLC

  • Physical Therapist
  • Rockford, IL
  • NPI 1891330882
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1073373411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 MCFARLAND RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076806",
            "telephone_number": "815-227-1700",
            "fax_number": "815-227-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N UNION ST",
            "city": "BYRON",
            "state": "IL",
            "postal_code": "610108626",
            "telephone_number": "815-234-5553",
            "fax_number": "815-234-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASSINGHAM",
        "first_name": "MALLORY",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.028112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "SCHILF",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Byron, IL
• Providers in Byron, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.