Mallory Boackle Tasseff, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH8787 Issued in AL

Practice address

7191 Cahaba Valley Rd Ste 102
Hoover, AL 35242-6507

Phone

(205) 408-6600

NPI assigned

May 24, 2023

Last updated

May 24, 2023By 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

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincents Ambulatory Healthcare Network LLCGroup PAC ID 1355608456, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• St Vincents Ambulatory Healthcare Network LLC

  • Physical Therapy Clinic/Center
  • Birmingham, AL
  • NPI 1891212494
  Medicare reassignment Care Compare group NPD
• St Vincents Ambulatory Healthcare Network LLC

  • Registered Dietitian
  • Birmingham, AL
  • NPI 1982121513
  NPD

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1235821679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 22ND ST S STE 1000",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352052881",
            "telephone_number": "205-408-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7191 CAHABA VALLEY RD STE 102",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352426507",
            "telephone_number": "205-408-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSEFF",
        "first_name": "MALLORY",
        "middle_name": "BOACKLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed N Gilani Innovativemedicalresources
• Synthesis Health & Wellness, LLC
• Sarah Jane Tallakson, ALC
• Taproot Therapy Collective
• Tara Vines , LLC
• Marilia Paiva Tate, D.M.D.
• Alon Tatsas, M.D.
• Taylor Flythe, DC, LLC
• Juanita Taylor, MS,RD
• Shannon Taylor, ND

• Physical Therapist in Hoover, AL
• Providers in Hoover, AL by specialty
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.