Mallory Jo Brooks, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

30895 Issued in TN

Practice address

2221 Jacksboro Pike Ste C4
La Follette, TN 37766-3007

Phone

(423) 566-3488

Fax

(866) 722-3453

NPI assigned

Oct 22, 2020

Last updated

Jul 8, 2025By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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.

• East Tennessee Children's Primary Care Center, Inc.

  dba Dolly Parton Children's Hospital Primary Care Center Inc

  • Pediatrics Physician
  • Knoxville, TN
  • NPI 1235350901
  NPD (past)

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1467051151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15004",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379015004",
            "telephone_number": "865-541-8895",
            "fax_number": "865-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 JACKSBORO PIKE STE C4",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377663007",
            "telephone_number": "423-566-3488",
            "fax_number": "866-722-3453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 N. Charles Seivers Blvd., Suite 4",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "TN",
            "postal_code": "377166705",
            "country_code": "US",
            "telephone_number": "865-457-4044",
            "fax_number": "866-699-4833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1705 Roane State Hwy",
            "address_purpose": "LOCATION",
            "city": "Harriman",
            "state": "TN",
            "postal_code": "377488306",
            "country_code": "US",
            "telephone_number": "865-316-5001",
            "fax_number": "865-376-3713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Oak Ridge Turnpike",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378306916",
            "country_code": "US",
            "telephone_number": "865-482-4088",
            "fax_number": "866-674-2033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "MALLORY",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "30895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q074118",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista A Bolton, NP
• Olivia A Bonds, M.S
• Caitlin Marie Boshears, COTA/L
• Hannah Marissa Bray, PHARMD
• Tristan Faith Brock, COTA/L
• Judith C Bryson, FNP
• Tammy Denise Buckner, RPH
• Lindsey Presley Bull, DO
• John S Burrell, M.D.
• Gary Adam Byrd

• Pediatric Nurse Practitioner in La Follette, TN
• Providers in La Follette, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.