Active NPI
Loralie Dimacali Malonzo
- Physical Therapist
- Birmingham, AL
National Provider Identifier
1184953960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2009032715
- Practice address
- 1920 Old Springville Rd
Suite 104
Birmingham, AL 35215 - Phone
- (800) 854-4589
- Fax
- (205) 520-0455
- NPI assigned
- Dec 8, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2009032715 | MO | Primary |
| Physical Therapist | 225100000X | 070.016201 | IL |
Addresses
Primary practice location
1920 Old Springville Rd
Suite 104
Birmingham, AL 35215
Mailing address
1920 Old Springville Road
Suite 104
Birmingham, AL 35215
Phone (205) 520-9600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WW0042880 | Other | PHILIPPINE PASSPORT NUMBER |
Other names 1
- Loralie Malonzo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.016201 | IL | MD | Physical Therapist |
| 2009032715 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260230400000",
"number": "1184953960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1920 OLD SPRINGVILLE ROAD",
"address_2": "SUITE 104",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35215",
"telephone_number": "205-520-9600",
"fax_number": "205-520-0455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1920 OLD SPRINGVILLE RD",
"address_2": "SUITE 104",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "35215",
"telephone_number": "800-854-4589",
"fax_number": "205-520-0455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONZO",
"first_name": "LORALIE",
"middle_name": "DIMACALI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-08",
"last_updated": "2009-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2009032715",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.016201",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHILIPPINE PASSPORT NUMBER",
"identifier": "WW0042880",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LORALIE",
"last_name": "MALONZO",
"credential": "PT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.