Sameer Ahmed Mallick, MBBS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

329 N State of Franklin Rd
Johnson City, TN 37604-6062

Phone

(423) 979-4100

Fax

(423) 979-4134

NPI assigned

Apr 21, 2023

Sex

Male

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: smallick2734780@direct.trinity-health.org

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1437846276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD",
            "address_2": "STE 205E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-439-8023",
            "fax_number": "423-439-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046062",
            "telephone_number": "423-979-4100",
            "fax_number": "423-979-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "SAMEER AHMED",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asaiel Makahleh, MD
• Maira Malik, MD
• Muhammad Owais Malik, MD
• Sulleman Malik, MD
• Anjali Malkani, M.D.
• Hailey Malone, LPN
• Haley Edwards Malone, APRN
• Management Care Corporation (Lakebridge Health Care Center)
• Nora Nery Manalo, MD
• Nicole M Mancini, DDS

• Student in an Organized Health Care Education/Training Program in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Student in an Organized Health Care Education/Training Program in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.