Mallory Nicole Gergely

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP014096 Issued in PA

Practice address

1010 Ligonier St
Latrobe, PA 15650-1846

Phone

(724) 589-8581

Fax

(724) 539-2739

NPI assigned

Aug 13, 2014

Last updated

Jan 24, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Mallory Nicole Gallucci Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Excela Health Physician Practices, Inc

  dba Excela Health Cardiology

  • Cardiovascular Disease Physician
  • Greensburg, PA
  • NPI 1821225202
  Medicare reassignment NPD
• Jade & Rory PLLC

  • Health Service Clinic/Center
  • West Newton, PA
  • NPI 1356107775
  NPD Authorized official
• Excela Health Physician Practices, Inc.

  dba Excela Health Ob-Gyn

  • Obstetrics & Gynecology Physician
  • Latrobe, PA
  • NPI 1164766473
  NPD
• Excela Health Physician Practices, Inc.

  dba Walk-in Clinic

  • Family Medicine Physician
  • Greensburg, PA
  • NPI 1235004193
  NPD
• Windber Hospital, Inc.

  dba Windber Medical Center

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1215346408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 JEFFERSON AVE",
            "address_2": "SUITE 400",
            "city": "JEANNETTE",
            "state": "PA",
            "postal_code": "156442538",
            "telephone_number": "724-527-8060",
            "fax_number": "724-522-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LIGONIER ST",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156501846",
            "telephone_number": "724-589-8581",
            "fax_number": "724-539-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGELY",
        "first_name": "MALLORY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "GALLUCCI",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• George M Gavin, MD
• Aleksandr V Gavrilov, RD, LDN
• Norman P Gebrosky, MD
• Genesis Rehab Services
• Marie Renee George Williams, D.O.
• Giant Eagle Inc (Giant Eagle Pharmacy 0082)
• Cynthia C Gladora, CRNA
• Scott Ivan Gobin
• Joseph Ronald Golden Jr., LPC
• Amber Goodenow

• Family Nurse Practitioner in Latrobe, PA
• Providers in Latrobe, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.