Individual provider Active NPI

Mary Angela Malone, DNP, APRN, ACNS-BC,

  • Adult Health Clinical Nurse Specialist
  • Louisville, KY
National Provider Identifier
1386257129
Registry record updated Aug 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
2012007564 Issued in KY
Practice address
529 S Jackson St
Louisville, KY 40202-3229
Phone
(502) 562-8021
NPI assigned
Aug 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 2012007564 KY Primary

Addresses

Primary practice location

529 S Jackson St
Louisville, KY 40202-3229

Mailing address

135 River Run
Georgetown, KY 40324-8444
Phone (859) 948-9473

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

LicenseStateTypeSpecialty
2012007564KYMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1386257129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 RIVER RUN",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248444",
            "telephone_number": "859-948-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023229",
            "telephone_number": "502-562-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MARY",
        "middle_name": "ANGELA",
        "credential": "DNP, APRN, ACNS-BC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KY",
            "license": "2012007564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.