Patrick Roy Malone

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14660 Issued in TX

Practice address

4900 Overton Ridge Blvd
Suite 214
Fort Worth, TX 76132-1940

Phone

(817) 370-1777

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1184648396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 OVERTON RIDGE BLVD",
            "address_2": "SUITE 214",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321940",
            "telephone_number": "817-370-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 OVERTON RIDGE BLVD",
            "address_2": "SUITE 214",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321940",
            "telephone_number": "817-370-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "PATRICK",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Malone, M.D.
• Hunter S Malone, LMSW
• Katie Elaine Malone, DNP, AGCNS-BC
• Mark A Malone, DDS
• Melodie Lynn Malone
• Susanne Marie Malone, LCSW
• Victoria Malone, LCSW
• Christina Maloney, RDLD
• Peter J Malouf, D.O.
• Agnes Jeruto Mamboleo

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.