Individual provider Active NPI

Rachel Mallett, RN, FNP-BC, MSN

  • Family Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1457730715
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2015015185 Issued in MO
Practice address
1601 E Broadway Ste 260
Columbia, MO 65201-8041
Phone
(573) 815-2221
Fax
(573) 815-5320
NPI assigned
May 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2015015185 MO Primary

Addresses

Primary practice location

1601 E Broadway Ste 260
Columbia, MO 65201-8041

Mailing address

1601 E Broadway Ste 260
Columbia, MO 65201-8041
Phone (573) 815-2221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20150709001965 MO Practitioner - Nurse Practitioner 1557673167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boone Physician Services LLCGroup PAC ID 6507090644, 243 clinicians

Practice addresses (Care Compare)

1601 E Broadway
Suite 260
Columbia, MO 65201-8041
Phone (573) 815-5310

Hospital & facility affiliations

  • Boone Hospital Center Hospital, Columbia, MO, CCN 260068
  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Gynecology Specialists, LLC CurrentSince Jul 1, 2019 Accepting new patients
Boone Physician Services, LLC CurrentSince Oct 7, 2024 Accepting new patients
CH Allied Services, Inc Past Accepting new patients
Sara E. Crowder, MD Past Accepting new patients

Locations

1601 E Broadway
Ste 260
Columbia, MO 65201
Phone (573) 815-2221

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1605 E Broadway
Ste 220
Columbia, MO 65201
Phone (573) 442-2221

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

1605 E Broadway
Ste 260
Columbia, MO 65201
Phone (573) 442-2221

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1457730715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY STE 260",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018041",
            "telephone_number": "573-815-2221",
            "fax_number": "573-815-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E BROADWAY STE 260",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018041",
            "telephone_number": "573-815-2221",
            "fax_number": "573-815-5320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETT",
        "first_name": "RACHEL",
        "credential": "RN, FNP-BC, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-20",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2015015185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.