Mark Allen Malmstrom, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT002428 Issued in OH

Practice address

4440 Glen Este Withamsville Rd
Cincinnati, OH 45245-1318

Phone

(513) 943-3630

Fax

(513) 753-4308

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Orthopaedic Consultants of Cincinnati, Inc.

  • Orthopaedic Surgery Physician
  • Cincinnati, OH
  • NPI 1396792529
  NPD (past)
• Tristate Physical Therapy, LLC

  • Physical Therapist
  • Hagerstown, MD
  • NPI 1801146626
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1154301885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 CREEK RD",
            "address_2": "STE 110",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-733-9333",
            "fax_number": "513-588-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 GLEN ESTE WITHAMSVILLE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452451318",
            "telephone_number": "513-943-3630",
            "fax_number": "513-753-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALMSTROM",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT002428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2631398",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00323522",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000384741",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "479351",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Joseph Malloy
• Jessica Malloy
• Paula J Malloy, LSW
• Tiffany N Malloy, APRN
• Amy L Malmedahl, NP
• Donald Henry Malnofski, DDS
• Bobbie Malone
• Brigid Coleen Malone, CNP
• Dernae K Malone
• Holly Christina Malone

• Physical Therapist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; 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.