Mary Kaitlin Malick

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

32769 Issued in TN

Practice address

1453 Hope Way
Murfreesboro, TN 37129-3140

Phone

(615) 893-9390

NPI assigned

Mar 1, 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

Medicare fee-for-service enrollment

Enrolled in TN

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

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 and National Provider Directory roles.

• Meharry Medical College

  • Clinic/Center
  • Nashville, TN
  • NPI 1205859279
  Medicare reassignment
• Rutherford County Primary Care

  • Federally Qualified Health Center (FQHC)
  • Murfreesboro, TN
  • NPI 1114973237

  Family

  NPD

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1093272601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 HOPE WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293140",
            "telephone_number": "615-893-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 HOPE WAY",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293140",
            "telephone_number": "615-893-9390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICK",
        "first_name": "MARY",
        "middle_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "TN",
            "license": "0000235073",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Maignan
• Bryan Edward Mainhardt, DMD
• Molly Maino, RBT
• Tifany Lyne Makuch, MSN, WHNP-BC
• Jessica Maldonado
• Muhammad Fayaz Malik, MD
• Eliza Echavez Mall, DNP
• Jack Daniel Mallette, DDS
• James Mallette, OTR/L
• Melinda Beckman Mallette, MD

• Family Nurse Practitioner in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.