Haley C Mallory, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3016595 Issued in KY

Practice address

440 E Happy Valley St
Cave City, KY 42127-8844

Phone

(270) 773-2111

Fax

(270) 773-2117

NPI assigned

Apr 26, 2022

Last updated

Mar 2, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: haley.mallory@tjrh.cernerdirect.com

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.

• T J Samson Community Hospital

  dba T J Health Cave City

  • Rural Health Clinic/Center
  • Cave City, KY
  • NPI 1629429360
  Medicare reassignment NPD
• T J Samson Community Hospital

  • Family Medicine Physician
  • Glasgow, KY
  • NPI 1477609865
  NPD
• T J Samson Community Hospital

  dba T J Samson Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Glasgow, KY
  • NPI 1922343300

  Family

  NPD
• T J Samson Community Hospital

  • Skilled Nursing Facility
  • Glasgow, KY
  • NPI 1760475925
  NPD (past)

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1275277121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 E HAPPY VALLEY ST",
            "city": "CAVE CITY",
            "state": "KY",
            "postal_code": "421278844",
            "telephone_number": "270-773-2111",
            "fax_number": "270-773-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E HAPPY VALLEY ST",
            "city": "CAVE CITY",
            "state": "KY",
            "postal_code": "421278844",
            "telephone_number": "270-773-2111",
            "fax_number": "270-773-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "HALEY",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100810630",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Haley.Mallory@tjrh.cernerdirect.com",
            "affiliation": "N",
            "address_1": "440 E Happy Valley St",
            "city": "Cave City",
            "state": "KY",
            "country_code": "US",
            "postal_code": "421278844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• James Parker Crews
• Elbert Olin Jent Jr., RPH
• Jonathan L Morris, APRN
• Karissa Gwen Newberry, SLP
• Nexus Lab 2.0 LLC
• Nexus Lab, Inc.
• Parmet Inc (Parkland Drugs)

• Family Nurse Practitioner in Cave City, KY
• Providers in Cave City, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.