Stephen Mallary, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

028600 Issued in GA

Practice address

567 Arlington PL
Macon, GA 31201-1704

Phone

(478) 745-9206

Fax

(478) 738-0758

NPI assigned

Nov 16, 2006

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

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• MCG Eap Services, Inc.

  • Professional Counselor
  • Macon, GA
  • NPI 1700839735

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366515645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 ARLINGTON PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011704",
            "telephone_number": "478-745-9206",
            "fax_number": "478-738-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 ARLINGTON PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011704",
            "telephone_number": "478-745-9206",
            "fax_number": "478-738-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARY",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "028600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunice Malave de Leon
• Justin Marshall Malcom, MSN, NP-C
• Laura Malcom, NP-C
• Premila Malhotra, MD
• Jamal Malik
• Jessica Annelle Malone, NP-C
• Dennis Malto
• Carla Gay Abad Manaois, OTR/L
• Samuel David Mandel, MD
• Lindsey Mangham

• Psychiatry Physician in Macon, GA
• Providers in Macon, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.