Palen Powelson Mallory, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5765 Issued in GA

Practice address

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049

Phone

(404) 778-1401

NPI assigned

Apr 11, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmallory410393@direct.medicine.duke.edu

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.

• Duke Health Integrated Practice, Inc.

  • General Practice Physician
  • Durham, NC
  • NPI 1205553369
  Medicare reassignment NPD

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1245596535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BRIARVISTA WAY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293642",
            "telephone_number": "804-357-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-778-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "PALEN",
        "middle_name": "POWELSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "5765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Mallette, M.ED, NCC, APC
• Tarun Mallipeddi, MD
• Alexis Mallis
• Kristy Mallon
• Michael Mallory, MD, MPH
• Sharon Tyler Mallory, NP
• Jasmin Jelissa Malloy, CRNA
• Tiffany Malloy
• Pranava Mallu
• Christian Malone

• Pediatrics Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.