Mallory B Puckett, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.022510 Issued in OH

Practice address

4143 Fulton Dr NW
Canton, OH 44718-2819

Phone

(330) 244-8888

Fax

(330) 244-8850

NPI assigned

Mar 14, 2018

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

Medicare fee-for-service enrollment

Enrolled in OH

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Care Inc.Group PAC ID 1052207727, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Summa Health System Hospital, Akron, OH, CCN 360020
• Mercy Medical Center Hospital, Canton, OH, CCN 360070

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpuckett@scp.medentdirect.com
• Direct secure messaging: mallory.puckett@chci.eclinicaldirectplus.com

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.

• Community Health Care Inc.

  • Family Medicine Physician
  • Canal Fulton, OH
  • NPI 1114902137
  Medicare reassignment Care Compare group NPD
• Stark County Physicians LLC

  • Internal Medicine Physician
  • Canton, OH
  • NPI 1154695815
  Medicare reassignment NPD
• Town Park Physical Therapy & Wellness Center LLC

  • Physical Therapist
  • Ashland, OH
  • NPI 1649669110
  NPD
• Radiology Associates of Canton, Inc.

  • Diagnostic Radiology Physician
  • Canton, OH
  • NPI 1912982034
  NPD (past)

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

• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Care Compare affiliation
• Summa Health System

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1295036762

  Hospital

  Care Compare affiliation
• Summa Health System

  • General Acute Care Hospital
  • Akron, OH
  • NPI 1396765681
  Care Compare affiliation
• Summa Health System

  • Clinical Medical Laboratory
  • Barberton, OH
  • NPI 1609263706

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1447753520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 BOETTLER RD STE 100",
            "city": "UNIONTOWN",
            "state": "OH",
            "postal_code": "446857793",
            "telephone_number": "330-896-0009",
            "fax_number": "330-896-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4143 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182819",
            "telephone_number": "330-244-8888",
            "fax_number": "330-244-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Boettler Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Uniontown",
            "state": "OH",
            "postal_code": "446857793",
            "country_code": "US",
            "telephone_number": "330-896-0009",
            "fax_number": "330-896-0032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "387 3rd St",
            "address_purpose": "LOCATION",
            "city": "Bergholz",
            "state": "OH",
            "postal_code": "439087963",
            "country_code": "US",
            "telephone_number": "740-768-1001",
            "fax_number": "740-841-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "MALLORY",
        "middle_name": "B",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHELICENSE",
            "identifier": "APRN.CNP.022510",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0289079",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Ann Pryor
• Mary Elizabeth Przybysz, M.D.
• Psychological & Educational Solutions, LLC
• Psychological & Family Consultants, Inc.
• Samantha Pucci, COTA/L
• Donna Martelia Pugh, QMHS
• Vida Nicole Pugh
• Brooke Puharic
• Riley Suzanne Pullen
• Dawn Pullin, LPC

• Family Nurse Practitioner in Canton, OH
• Providers in Canton, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.
• 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.