Mallory Louise Willis, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2943 Issued in AL

Practice address

1171 Gatewood Drive
#101
Auburn, AL 36830

Phone

(334) 821-2708

Fax

(334) 528-5420

NPI assigned

Apr 1, 2019

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

Other names 1

• Mallory Louise Waller Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Medicine Associates, LLCGroup PAC ID 7214089432, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Homecare of East Alabama Medical Center Home health agency, Auburn, AL, CCN 017129
• Enhabit Home Health Home health agency, Troy, AL, CCN 017324
• The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029

Merit-based Incentive Payment System (MIPS)

Final score

85.51 of 100Reported as group

Quality

79.01

Promoting interoperability

99

Improvement activities

40

Cost

73.53

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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 and National Provider Directory roles.

• Primary Medicine Associates, LLC

  • Family Medicine Physician
  • Auburn, AL
  • NPI 1407099286
  Medicare reassignment Care Compare group NPD
• Annsheng Chinese Medicine, LLC

  • Acupuncturist
  • Alameda, CA
  • NPI 1790414027
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Alabama Medical Center Homecare, LLC

  • Home Health Agency
  • Auburn, AL
  • NPI 1770717738
  Care Compare affiliation
• Eh Health Home Health of Alabama, LLC

  • Home Health Agency
  • Troy, AL
  • NPI 1366904161
  Care Compare affiliation
• The East Alabama Health Care Authority

  • General Acute Care Hospital
  • Opelika, AL
  • NPI 1154386431
  Care Compare affiliation

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306308309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 GATEWOOD DRIVE",
            "address_2": "#101",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-821-2708",
            "fax_number": "334-528-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 GATEWOOD DRIVE",
            "address_2": "#101",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "36830",
            "telephone_number": "334-821-2708",
            "fax_number": "334-528-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "MALLORY",
        "middle_name": "LOUISE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "2943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA MEDICAL LICENSE",
            "identifier": "2943",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "WALLER",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Portia Williams, ATC/L
• Robin Williams
• Joyce Williford, FNP-C
• Laura Bryce Willis, MCD
• Lawendy Meadows Willis
• Raegan Thompson Willoughby
• Alexia M Wilson, OT
• Brianna Wilson
• Danielle Elyse Wilson
• Jess Wilson

• Family Medicine Physician in Auburn, AL
• Providers in Auburn, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.
• 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.