Mallory Powell, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1170341 Issued in TX

Practice address

12661 W State Highway 29
Liberty Hill, TX 78642-4729

Phone

(512) 778-5111

Fax

(512) 260-8103

NPI assigned

Aug 2, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Michael C. Holmes, MD, PLLC

  • Pediatrics Physician
  • Cedar Park, TX
  • NPI 1689132540

  Single Specialty

  NPD (past)
• Whitestone Pediatrics Incorporated

  • Primary Care Clinic/Center
  • Cedar Park, TX
  • NPI 1700170313
  NPD (past)

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1417787631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12661 W STATE HIGHWAY 29",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424729",
            "telephone_number": "512-778-5111",
            "fax_number": "512-260-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12661 W STATE HIGHWAY 29",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424729",
            "telephone_number": "512-778-5111",
            "fax_number": "512-260-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "MALLORY",
        "credential": "CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1170341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tejal Patel
• Peter H Sutton Dentistry PLLC (True Smile Orthodontics)
• Christina Philburn, LCSW
• Russel W. Polk, DC
• Jeffry Vincent Popham, D.C.
• Pure Primary Care, PLLC
• Courtney Pyle
• Lauren Struck Ranney, LPC
• Reagan Reitmeyer, LPC
• Renew Psychiatric Associates, PLLC

• Pediatric Nurse Practitioner in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.