Nancy Mallory, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M8876 Issued in ID

Practice address

435 S Eagle Rd
Eagle, ID 83616-6067

Phone

(208) 939-8200

NPI assigned

May 13, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1083665129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 S EAGLE RD",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166067",
            "telephone_number": "208-939-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 S EAGLE RD",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166067",
            "telephone_number": "208-939-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "NANCY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-13",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M8876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayven Macnab
• Kristin Adrianne Mahaffey, MFT-C
• Jennifer Mahlberg-Grant, APRN
• Melissa Major, NP-C
• Mallory Murphy
• Kirsten Malmendier, LICENSED ACUPUNCTURI
• Jennifer Maltby, D.C.
• John Knox Maltby II, D.C.
• Melanie Maltese, FNP-C
• Manity Inc

• Family Medicine Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.