NPIMap

Individual provider Active NPI

Mallory Nicole Schultz, AGACNP-BC

  • Nurse Practitioner
  • Port Huron, MI
National Provider Identifier
1497532436
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704313474 Issued in MI
Practice address
1170 Michigan Rd
Port Huron, MI 48060-4658
Phone
(810) 987-1700
NPI assigned
Sep 13, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 11

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 13

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

View all 13

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rau Physical Therapy Inc 98 clinicians
Mymichigan Medical Center Saginaw 111 clinicians

Practice addresses (Care Compare)

193 E Jefferson St
Frankenmuth, MI 48734-1935

4677 Towne Centre Rd
Suite 301
Saginaw, MI 48604-2848
Phone (855) 298-9888

Hospital & facility affiliations

  • Mymichigan Medical Center Saginaw Hospital, Saginaw, MI, CCN 230077
  • Saint Mary'S Standish Community Hospital Hospital, Standish, MI, CCN 231305
  • Tawas St Joseph Hospital Hospital, Tawas City, MI, CCN 230100
  • Mymichigan Medical Center Alpena Hospital, Alpena, MI, CCN 230036
  • Mymichigan Medical Center West Branch Hospital, West Branch, MI, CCN 230095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231117001724 MI Practitioner - Nurse Practitioner 1759738446 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Saginaw CurrentSince Nov 1, 2023 Accepting new patients
Mymichigan Medical Center Saginaw Current Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Nov 1, 2023 Accepting new patients
Mymichigan Medical Center Saginaw Past Accepting new patients

Locations

9900 Birch Run Rd
Ste D
Birch Run, MI 48415
Phone (989) 624-1575

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

3570 Shattuck Rd
Saginaw, MI 48603
Phone (989) 792-5353

4677 Towne Centre Rd
Ste 301
Saginaw, MI 48604
Phone (517) 799-8712

Interoperability endpoints

  • Direct secure messaging: mschultzreed116991@mymichiganhealth.midirect.net
  • Direct secure messaging: mallory.schultz.1@11016.direct.athenahealth.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704313474 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

1170 Michigan Rd
Port Huron, MI 48060-4658

Mailing address

3025 Blossom Cir
Saginaw, MI 48603-5208
Phone (989) 701-0276

Other names 1

NPPES NPI Registry
  • Mallory Reed Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 13, 2023.

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1497532436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 BLOSSOM CIR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486035208",
            "telephone_number": "989-701-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 MICHIGAN RD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604658",
            "telephone_number": "810-987-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "MALLORY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704313474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "REED",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.