Mallory Elyse Mowdy, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R877141 Issued in MS

Practice address

724 N Jackson St
Brookhaven, MS 39601-2460

Phone

(601) 833-5255

Fax

(601) 843-0252

NPI assigned

Aug 26, 2014

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 identifiers 2

Other names 1

• Mallory Elyse Magee Former name

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Extended Care Clinical Services, LLCGroup PAC ID 5092137844, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sta Home Health Agency of Jackson, Inc. Dba Accentcare Home Health of Jackson Home health agency, Clinton, MS, CCN 257102
• Arden Home Health of West Ms, LLC Home health agency, Ridgeland, MS, CCN 257115
• King'S Daughters Medical Center-Brookhaven Hospital, Brookhaven, MS, CCN 250057

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmowdy@eccs.kareodirect.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Extended Care Clinical Services LLC

  • Primary Care Clinic/Center
  • Brookhaven, MS
  • NPI 1134741945

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Extended Care Clinical Services LLC

  • Primary Care Clinic/Center
  • Brookhaven, MS
  • NPI 1134741945
  Medicare reassignment Care Compare group NPD Authorized official
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pearl, MS
  • NPI 1043236326
  Medicare reassignment NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Health Clinic/Center
  • Batesville, MS
  • NPI 1700349222
  Medicare reassignment NPD
• Premier NP Inc

  • Family Nurse Practitioner
  • Talladega, AL
  • NPI 1063904977

  MS

  Medicare reassignment NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Piney Woods, MS
  • NPI 1437412996
  NPD
• Family Health Care Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • Flowood, MS
  • NPI 1689440133
  NPD
• Strategic Solutions-Panola Medical Center LLC

  • Rural Acute Care Hospital
  • Batesville, MS
  • NPI 1053873307
  NPD

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

• King'S Daughters Medical Center

  • General Acute Care Hospital
  • Brookhaven, MS
  • NPI 1972503464
  Care Compare affiliation
• Mid-Delta Home Health, Inc.

  • Home Health Agency
  • Belzoni, MS
  • NPI 1649295684
  Care Compare affiliation
• Sta-Home Health Agency of Jackson, Inc.

  • Home Health Agency
  • Clinton, MS
  • NPI 1356482749
  Care Compare affiliation

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1427458553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N JACKSON ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012460",
            "telephone_number": "601-833-5255",
            "fax_number": "601-843-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N JACKSON ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012460",
            "telephone_number": "601-833-5255",
            "fax_number": "601-843-0252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWDY",
        "first_name": "MALLORY",
        "middle_name": "ELYSE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R877141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02337065",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1427458553",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "MAGEE",
            "middle_name": "ELYSE",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Charles Sherwood Mobley, D.C.
• Ramiro A Montalvo Jr., M.D.
• Joseph S Mooney, M.D.
• Daniel Moore, NURSE PRACTITIONER
• Darlene Moore
• Ms State Hospital Crisis Intervention Center-Brookhaven
• Brittany Griffin Mullins, NP-C
• David D Mullins, LMFT
• Gregory L Myrick, CRNA
• Robin D Nations, MD

• Family Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.