Individual provider Active NPI

Mallory Gahm, APRN, FNP-C

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1205393675
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP140741 Issued in TX
Practice address
6651 Main St FL 21
Houston, TX 77030-2351
Phone
(832) 824-3278
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP140741 TX Primary

Addresses

Primary practice location

6651 Main St FL 21
Houston, TX 77030-2351

Mailing address

6651 Main St FL 21
Houston, TX 77030-2351

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200122001965 TX Practitioner - Nurse Practitioner 5799110615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Childrens Physician GroupGroup PAC ID 4385722081, 661 clinicians

Practice addresses (Care Compare)

6701 Fannin St
Houston, TX 77030-2608
Phone (832) 824-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP140741TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Jan 6, 2020 Accepting new patients

Locations

6651 Main St
Fl 21
Houston, TX 77030
Phone (832) 824-3278

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6651 Main St
Ste E1920
Houston, TX 77030
Phone (832) 826-5048

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

Interoperability endpoints

  • Direct secure messaging: mgahm64044@prddirect.texaschildrens.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1205393675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 MAIN ST FL 21",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6651 MAIN ST FL 21",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302351",
            "telephone_number": "832-824-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAHM",
        "first_name": "MALLORY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP140741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.