Mallory McKay Rose, DPT
Individual provider Active NPI Physical Therapist · Brimingham, AL
NPI 1194358937 · NPPES record last updated Feb 20, 2020
Key facts
- NPI
- 1194358937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PTH9731 (AL)
- Practice address
- 7191 Cahaba Valley Road
Brimingham, AL 35242 - Phone
- (205) 408-6600
- Fax
- (205) 408-6459
- NPI assigned
- Feb 20, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Encore Rehabilitation, Inc
Practice addresses (Care Compare)
5643 Sermon Rd S
B
Theodore, AL 36582-3608
Phone (251) 660-1505
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201023001700 | AL | Practitioner - Physical Therapist in Private Practice | 4688094055 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTH9731 | AL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Encore Rehabilitation, Inc | Physical Therapist | Current |
Accepting new patients |
| Encore Rehabilitation, Inc. | Physical Therapist | Current |
Accepting new patients |
| Bayside Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
251 Johnston St SE
Ste 200
Decatur, AL 35601
251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708
341 Greeno Rd N
Ste 102
Fairhope, AL 36532
Phone (251) 928-9954
1622 N McKenzie St
Foley, AL 36535
Phone (251) 928-9954
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH9731 | AL | Yes |
Addresses
Primary practice location
7191 Cahaba Valley Road
Brimingham, AL 35242
Mailing address
7191 Cahaba Valley Road
Brimingham, AL 35242
Phone (205) 408-6600
Other providers in Brimingham, AL
All providers in Brimingham, AL · Physical Therapist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.