Kevin James Malloy

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

456 SW Monroe Ave
Corvallis, OR 97333-4781

Phone

(541) 791-3411

NPI assigned

Mar 10, 2020

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1184259137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 SW MONROE AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334781",
            "telephone_number": "541-791-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 SW MONROE AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334781",
            "telephone_number": "541-791-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmalloy@chancerecovery.org",
            "affiliation": "N",
            "address_1": "456 SW Monroe Ave",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973334781",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmalloy@chancerecovery.org",
            "affiliation": "N",
            "address_1": "456 SW Monroe Ave",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973334781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Maire, D.O.
• Emily Wellington Maize, IBCLC
• Camilia Makhyoun, D.O.
• Shari Lynne Malago
• Leon H Malkin, MD
• Jennifer Karina Malm, LMT
• Chiharu Tachi Malone IX, LPC
• Jessica M Malone, M.D.
• Madison Dietrich Malone, DDS
• Michael J Malos, MD

• Peer Specialist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.