Mallori Weaver Hernandez, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1057095 Issued in TX

Practice address

11673 Jollyville Rd Ste 202
Austin, TX 78759-4211

Phone

(512) 342-7979

Fax

(512) 637-2596

NPI assigned

Oct 18, 2021

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

Enrolled in TX

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

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.mallorihernandez@136732.advancedmd-direct.com
• FHIR API: https://api.platform.athenahealth.com/24508/brand/1/csg/1/fhir/r4

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.

• Progressive Behavioral Health, PLLC

  • Mental Health Counselor
  • Friendswood, TX
  • NPI 1659567238

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Northwest Psychiatry PA

  • Psychiatry Physician
  • Austin, TX
  • NPI 1225297344
  Medicare reassignment NPD

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1104589183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 LAKELINE MALL DR APT 4202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787170078",
            "telephone_number": "512-214-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11673 JOLLYVILLE RD STE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594211",
            "telephone_number": "512-342-7979",
            "fax_number": "512-637-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MALLORI",
        "middle_name": "WEAVER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1057095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liana Hernandez, LCSW
• Linda Lorena Hernandez, CNA
• Lita Hernandez, RPH
• Lizzette Hernandez
• Maegen Hernandez
• Maria G. Hernandez
• Maria Paula Hernandez, SLP
• Mark Hernandez, PT
• Mark Steven Hernandez, M.D.
• Mayra Hernandez, CCC-SLP

• Psychiatric/Mental Health Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.
• 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.