Mary C Lally, BMBCH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42083 Issued in IA

Practice address

901 Montgomery St
Decorah, IA 52101-2325

Phone

(563) 382-2911

Fax

(563) 387-3102

NPI assigned

Jun 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary C Baran Former name

Medicare fee-for-service enrollment

Enrolled in NE

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

Specialty

HospitalistAlso: Family Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CHI Health Clinic Specialty LLCGroup PAC ID 4789098443, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health St. Elizabeth Hospital, Lincoln, NE, CCN 280020
• CHI Health Nebraska Heart Hospital, Lincoln, NE, CCN 280128
• Community Medical Center, Inc Hospital, Falls City, NE, CCN 281352

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• CHI Health Clinic Specialty, LLC

  • Hospitalist Physician
  • Lincoln, NE
  • NPI 1285138065

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Saint Elizabeth Regional Medical Center

  dba CHI Health St. Elizabeth

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1336155738
  NPD (past)

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

• Community Medical Center, Inc.

  • Critical Access Hospital
  • Falls City, NE
  • NPI 1881643484
  Care Compare affiliation
• Nebraska Heart Hospital

  dba CHI Health Nebraska Heart

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1699718437
  Care Compare affiliation
• Saint Elizabeth Regional Medical Center

  dba CHI Health St. Elizabeth

  • General Acute Care Hospital
  • Lincoln, NE
  • NPI 1336155738
  Care Compare affiliation

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1417242587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-2911",
            "fax_number": "563-387-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-2911",
            "fax_number": "563-387-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALLY",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "BMBCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "42083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BARAN",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christina H. Krouse-Gagne, OTR/L
• Kim Kuennen
• Steven Lee Kurth, DDS
• Nicole A Kuykendall, PT, DPT
• Michael F Labelle, MD
• Lana W. McDermott, DDS PC
• Gregory Lindsey Lane, MS PT
• Sandra K Larson, PT
• Virginia L. Leidahl, BA, LBSW
• Elizabeth K Leschensky, FNPC

• Family Medicine Physician in Decorah, IA
• Providers in Decorah, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.