Individual provider Active NPI

Mallory Welter Scelfo, FNP-C

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1467215285
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
228816 Issued in OK
Practice address
206 Wanderlust CT
Johnson City, TN 37604-3248
Phone
(228) 860-7831
NPI assigned
Feb 5, 2024
Last updated
Jun 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU
Family Nurse Practitioner 363LF0000X 228816 OK Primary

Addresses

Primary practice location

206 Wanderlust CT
Johnson City, TN 37604-3248

Mailing address

206 Wanderlust CT
Johnson City, TN 37604-3248
Phone (228) 860-7831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240424002739 TN Practitioner - Nurse Practitioner 3375983307 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Associates, P.a. CurrentSince Apr 4, 2024 Accepting new patients
Allergy Associates, PA CurrentSince Apr 4, 2024 Accepting new patients
Leconte Radiology PC Past Accepting new patients
Allergy Associates, PA Past Accepting new patients

Locations

1410 Tusculum Blvd
Ste 2300
Greeneville, TN 37745
Phone (423) 823-5190

2428 Knob Creek Rd
Ste 102
Johnson City, TN 37604
Phone (423) 794-1074

1 Sheridan Sq
Ste 104
Kingsport, TN 37660
Phone (423) 251-4441

6701 Baum Dr
Ste 140
Knoxville, TN 37919

801 N Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 584-8589

7560 Dannaher Dr
Ste 100
Powell, TN 37849
Phone (800) 600-7551

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1467215285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 WANDERLUST CT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043248",
            "telephone_number": "228-860-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 WANDERLUST CT",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043248",
            "telephone_number": "228-860-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCELFO",
        "first_name": "MALLORY",
        "middle_name": "WELTER",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "228816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.