Zachary Mallette

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306605686 Issued in VA

Practice address

1921 Maple Shade Dr
Virginia Beach, VA 23453-6689

Phone

(757) 329-2903

NPI assigned

Jul 15, 2024

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Therapy on the Move

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1881422707
  NPD

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1306684337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 MAPLE SHADE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234536689",
            "telephone_number": "757-329-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 MAPLE SHADE DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234536689",
            "telephone_number": "757-329-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETTE",
        "first_name": "ZACHARY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306605686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgardo Gabriel Malinis Jr., RRT
• Ashley Malito
• Irene Marie Mallenbaum, LCSW
• Brenda W. Mallery, LCSW
• Lauren Mallette, OTR/L
• Kim Mallon
• Dale Larrie Mallory, D.D.S.
• Shanita Mallory, LPC
• Zhavon Malone, EDS
• Martha Leeanna Malpass-Hauert, LPC

• Physical Therapy Assistant in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.