Edna Elaine Mallory, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN185828 Issued in GA

Practice address

2169 W Point Rd
Lagrange, GA 30240-4002

Phone

(706) 902-9516

NPI assigned

Sep 28, 2012

Last updated

Oct 23, 2025By 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 2

Addresses

Other names 1

• E Elaine Mallory Other name

Medicare fee-for-service enrollment

Enrolled in GA, AL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emallory333096@direct.ochin.org

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.

• Quality of Life Health Services Inc

  dba Quality of Life Health Complex

  • Community Health Clinic/Center
  • Gadsden, AL
  • NPI 1447200977
  Medicare reassignment
• Quality of Life Health Services, Inc

  dba Calhoun Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Anniston, AL
  • NPI 1013339209
  NPD
• Quality of Life Health Services, Inc

  dba Susie E. Allen Health Center

  • Federally Qualified Health Center (FQHC)
  • Phenix City, AL
  • NPI 1831568237
  NPD

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1255682381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ELY CALLAWAY ROAD",
            "city": "WEST POINT",
            "state": "GA",
            "postal_code": "31833",
            "telephone_number": "706-885-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2169 W POINT RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404002",
            "telephone_number": "706-902-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "EDNA",
        "middle_name": "ELAINE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-28",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN185828",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-108083",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "E",
            "last_name": "MALLORY",
            "middle_name": "ELAINE",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Grant R Major, M.D.
• Grant Ralston Major II, M.D.
• John Woody Major, MD
• Sana Masood Makhdoom, M.D.
• John William Carl Carter Mallett, MD
• Kristin Lauren Mallory, NP
• Lavanya Manimaran, MD
• Karen G Manning, CNP
• Terry Lynn Manning
• Anthony Marchetti

• Family Nurse Practitioner in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.