Mallory Radvansky, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.14103 Issued in OH

Practice address

425 W 5TH St
East Liverpool, OH 43920-2405

Phone

(330) 386-5279

Fax

(330) 386-5866

NPI assigned

Jan 22, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH, WV2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Trinity Hospital Holding CompanyGroup PAC ID 0244123834, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Medical Ctr East &Trinity Medical Ctr West Hospital, Steubenville, OH, CCN 360211

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FBJFBA

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.

• Trinity Hospital Holding Company

  • General Acute Care Hospital
  • Steubenville, OH
  • NPI 1285715144
  Medicare reassignment Care Compare group NPD
• River Valley Physicians, LLC

  • Multi-Specialty Clinic/Center
  • East Liverpool, OH
  • NPI 1891756870

  WV

  Medicare reassignment NPD
• Trinity Hospital Holding Company

  • Anesthesiology Physician
  • Steubenville, OH
  • NPI 1144739996
  NPD
• Openloop Healthcare Partners PC

  • General Practice Physician
  • Des Moines, IA
  • NPI 1245820661
  NPD (past)

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

• Trinity Hospital Holding Company

  • General Acute Care Hospital
  • Steubenville, OH
  • NPI 1285715144
  Care Compare affiliation

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

{
    "created_epoch": "1358812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1376881607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645409",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152645252",
            "telephone_number": "330-386-6442",
            "fax_number": "330-386-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 5TH ST",
            "city": "EAST LIVERPOOL",
            "state": "OH",
            "postal_code": "439202405",
            "telephone_number": "330-386-5279",
            "fax_number": "330-386-5866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15655 State Route 170 Ste B",
            "address_purpose": "LOCATION",
            "city": "East Liverpool",
            "state": "OH",
            "postal_code": "439209672",
            "country_code": "US",
            "telephone_number": "330-932-0909",
            "fax_number": "330-932-0769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADVANSKY",
        "first_name": "MALLORY",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-22",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015019",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.14103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01326293",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0079443",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Psycare Inc
• Psycare Inc
• Psycare Inc.,
• Kali Purnell, LISW
• R W. Beatty, M.D., Inc.
• Tammy Rafferty, LPCCS
• Jade Nicole Raffle, LPN
• Rainbow Counseling Center, Inc.
• Pamela Rastetter
• Nicole Ann Rawlings, FNP-C

• Family Nurse Practitioner in East Liverpool, OH
• Providers in East Liverpool, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.