Mallory Iverson, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209013043 Issued in IL

Practice address

431 W Liberty St
Wauconda, IL 60084-2452

Phone

(847) 526-2151

NPI assigned

Aug 20, 2015

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Medicine Specialists of Round Lake Incorporated S CGroup PAC ID 6002957511, 20 clinicians

Family Medicine Specialists S.C.Group PAC ID 0042206252, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
• Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
• Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mallory.iverson@fms.eclinicaldirectplus.com

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.

• Family Medicine Specialists of Round Lake Incorporated S C

  • Family Medicine Physician
  • Round Lake Beach, IL
  • NPI 1740515253
  Medicare reassignment Care Compare group NPD
• Family Medicine Specialists, S.C.

  • Family Medicine Physician
  • Wauconda, IL
  • NPI 1063406601
  Medicare reassignment Care Compare group NPD
• Family Medicine Specialists of Mount Prospect S C

  • Family Medicine Physician
  • Mt Prospect, IL
  • NPI 1437389475
  Medicare reassignment NPD

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

• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Barrington, IL
  • NPI 1447368071
  Care Compare affiliation
• Northern Illinois Medical Center

  • General Acute Care Hospital
  • McHenry, IL
  • NPI 1982611281
  Care Compare affiliation

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1366818692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6037",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600846037",
            "telephone_number": "847-526-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 W LIBERTY ST",
            "city": "WAUCONDA",
            "state": "IL",
            "postal_code": "600842452",
            "telephone_number": "847-526-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "MALLORY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlee Holland, DC
• Sara J Hollis, LCPC, M.A.
• Natalie Howard, PT
• Evan Hughes
• Illinois Bone and Joint Institute LLC
• Sarah Jakubek
• Barbara Jean Jesme, R.PH.
• Joey'S House NFP
• Erika Johnson, F.N.P.
• Jennifer Adele Jones, MS, OTR/L

• Nurse Practitioner in Wauconda, IL
• Providers in Wauconda, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.