Active NPI
Julie Ann Mallers
- Family Nurse Practitioner
- Crown Point, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71002367A
- Practice address
- 1121 S Indiana Ave
Crown Point, IN 46307-7205 - Phone
- (219) 663-2160
- NPI assigned
- Feb 20, 2008
- Last updated
- Mar 12, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71002367A | IN | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | 71002367 | IN |
Addresses
Primary practice location
1121 S Indiana Ave
Crown Point, IN 46307-7205
Mailing address
PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800
Other practice location 1
8345 Wicker Ave
Saint John, IN 46373-8879
Phone (219) 627-5077
Other practice location 2
1201 S Main St
Crown Point, IN 46307-8481
Phone (219) 757-6629
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmallers4750@Direct.FranciscanAlliance.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11275 Delaware Pkwy
Suite a
Crown Point, IN 46307-7812
Phone (219) 779-8735
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71002367A | IN | MD | Family Nurse Practitioner |
| 71002367 | IN | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indiana Sports & Medical Science Institute, PC | Current | Accepting new patients |
Locations
11275 Delaware Pkwy
Crown Point, IN 46307
Phone (219) 779-8735
11275 Delaware Pkwy
#A
Crown Point, IN 46307
Phone (219) 662-5530
Interoperability endpoints
- https://fhir.meditouchehr.com/api/fhir/r4/
- jmallers@isamsip-in.direct.office.nextgen.com
- jmallers4750@direct.franciscanalliance.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Crown Point, IN
- NPI 1609155290
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Powers Health Rehabilitation Center
- Rehabilitation Hospital
- Crown Point, IN
- NPI 1801301437
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Crown Point, IN
- NPI 1336205798
-
dba Community Hospital
- General Acute Care Hospital
- Munster, IN
- NPI 1003918210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1396913646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 781076",
"city": "DETROIT",
"state": "MI",
"postal_code": "482781076",
"telephone_number": "317-528-4800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 S INDIANA AVE",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463077205",
"telephone_number": "219-663-2160"
}
],
"practiceLocations": [
{
"address_1": "8345 Wicker Ave",
"address_purpose": "LOCATION",
"city": "Saint John",
"state": "IN",
"postal_code": "463738879",
"country_code": "US",
"telephone_number": "219-627-5077",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1201 S Main St",
"address_purpose": "LOCATION",
"city": "Crown Point",
"state": "IN",
"postal_code": "463078481",
"country_code": "US",
"telephone_number": "219-757-6629",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALLERS",
"first_name": "JULIE",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-20",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71002367A",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "IN",
"license": "71002367",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmallers4750@Direct.FranciscanAlliance.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1201 S Main St",
"city": "Crown Point",
"state": "IN",
"country_code": "US",
"postal_code": "463078481",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Crown Point, IN
- Sarosh Majeed, M.D.
- Majestic Care ABA in LLC
- Majestic Care ABA LLC
- Majestic Care of Crown Point Alf LLC (Saint Anthony Assisted Living)
- Major Hospital (Healthcare Center at Wittenberg Village)
- Mary E Malloy-Rhee, LSSW
- Kyrsten Anne Malloy
- Tameka Malone, MS CCC-SLP
- Natasha Mandula, DPM
- Emily Mangiaracina, OD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.