Mallori Phillips, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

091352 Issued in IA

Practice address

825 NE Gateway Dr Ste 124
Grimes, IA 50111-1307

Phone

(515) 500-6873

Fax

(515) 500-6874

NPI assigned

May 21, 2018

Sex

Female

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

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Eye State Optometry, LLC

  • Clinic/Center
  • Ames, IA
  • NPI 1477037000
  Medicare reassignment Authorized official
• KNJ Optometry PLC

  • Optometrist
  • Ankeny, IA
  • NPI 1568819647
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1326539826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CYCLONE LN",
            "city": "MADRID",
            "state": "IA",
            "postal_code": "501567610",
            "telephone_number": "515-293-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE GATEWAY DR STE 124",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501111307",
            "telephone_number": "515-500-6873",
            "fax_number": "515-500-6874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "814 W Bell Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "IA",
            "postal_code": "501383162",
            "country_code": "US",
            "telephone_number": "641-828-7993",
            "fax_number": "515-500-6874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1002 SE National Dr",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500213996",
            "country_code": "US",
            "telephone_number": "515-963-1112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MALLORI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "091352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Eirik Otteson, P.A.-C
• Paul L Ouverson, DPT
• Pediatric Speech Therapy
• Danielle Penton, PMHNP
• Jacob Frederick Phillips, DPT
• Pink Couch Wellness
• Daniel Arthur Plathe
• Matthew William Platt, D.D.S.
• Premier Foot & Ankle Surgeons of Iowa PLLC
• Primeserve LLC

• Optometrist in Grimes, IA
• Providers in Grimes, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.