Active NPI
Rebecca Lynn Malloy, REGISTERED NURSE
- Registered Nurse
- Holt, MI
National Provider Identifier
1346820396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704328507
- Practice address
- 2263 Cedar St
Holt, MI 48842-1202 - Phone
- (517) 694-2179
- NPI assigned
- Apr 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704328507 | MI | Primary |
Addresses
Primary practice location
2263 Cedar St
Holt, MI 48842-1202
Mailing address
6300 Timberland Dr
Dimondale, MI 48821-9755
Phone (517) 980-9226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704328507 | MI | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Michigan Inc | Past | Accepting new patients | |
| Rite Aid of Michigan Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Washington, MI
- NPI 1619117405
-
- Community/Retail Pharmacy
- Holt, MI
- NPI 1750490298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1346820396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6300 TIMBERLAND DR",
"city": "DIMONDALE",
"state": "MI",
"postal_code": "488219755",
"telephone_number": "517-980-9226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2263 CEDAR ST",
"city": "HOLT",
"state": "MI",
"postal_code": "488421202",
"telephone_number": "517-694-2179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLOY",
"first_name": "REBECCA",
"middle_name": "LYNN",
"credential": "REGISTERED NURSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-13",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704328507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.