Dwight M Malone

Primary specialty

DriverTaxonomy code 172A00000X

License

L2088992 Issued in AZ

Practice address

1505 N Country Club Dr Apt 118
Mesa, AZ 85201-2518

Phone

(480) 547-4960

NPI assigned

Jul 14, 2016

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Accountability Care Services LLC

  • Home Health Agency
  • Tempe, AZ
  • NPI 1023621745
  NPD

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1154774107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 N COUNTRY CLUB DR APT 118",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012518",
            "telephone_number": "480-547-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 N COUNTRY CLUB DR APT 118",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852012518",
            "telephone_number": "480-547-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "DWIGHT",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "AZ",
            "license": "L2088992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "812493202",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott N Maling, DPM
• Avi Meir Samuel Mallin, PA-C
• Cheryl B Mallory, LPC
• Jeffrey Grant Mallory, D.C.
• Rachelle Elvina Caldwell Mallory, RN
• Mercedes Maltbie, PHARMD
• Thomas Mammano, NMD
• Mammography Partners LLC
• Rania Mamo
• Samantha Manchik, LCSW

• Driver in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Driver in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.