Mallory Irene Chiang

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

200 Blue Moon Xing Ste 203
Pooler, GA 31322-9698

Phone

(912) 590-0973

Fax

(912) 590-0180

NPI assigned

Feb 13, 2024

Last updated

May 21, 2024By the provider in NPPES

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 GA

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

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Consultants in Pain Medicine LLCGroup PAC ID 7911975248, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128
• Candler Hospital Hospital, Savannah, GA, CCN 110024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mallory.chiang@jspc.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Consultants in Pain Medicine, LLC

  dba Centurion Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Brunswick, GA
  • NPI 1902852130
  Medicare reassignment Care Compare group NPD
• Consultants in Pain Medicine, LLC

  dba Centurion Spine & Pain Centers

  • Interventional Pain Medicine Physician
  • Savannah, GA
  • NPI 1942052022
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Saint Joseph's Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation
• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1174387773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY FL 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-256-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BLUE MOON XING STE 203",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229698",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Fair Rd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580800",
            "country_code": "US",
            "telephone_number": "912-590-0973",
            "fax_number": "912-590-0180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIANG",
        "first_name": "MALLORY",
        "middle_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cellgen Regenerative Medicine LLC
• Chatham Oral Surgery PC
• Chatham Orthopaedic Associates, PA
• Chatterbox Pediatric Therapy
• Gina Marie Cherico, PT, DPT
• Tchidi Patrick Chikere, BEHAVIORAL THERAPIST
• Candace Graves Christianson, CCC-SLP
• Amber Clark
• Dyneesha-Marie Clark
• Heather Clark

• Physician Assistant in Pooler, GA
• Providers in Pooler, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.