Active NPI
Sue A Malloy, ARNP
- Nurse Practitioner
- Humboldt, IA
National Provider Identifier
1518939693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- A-050489
- Practice address
- 1010 15TH St N
Humboldt, IA 50548-1008 - Phone
- (515) 332-2015
- NPI assigned
- Feb 3, 2006
- Last updated
- Sep 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | A-050489 | IA | Primary |
Addresses
Primary practice location
1010 15TH St N
Humboldt, IA 50548-1008
Mailing address
24 N 9TH St
Suite a
Fort Dodge, IA 50501-3909
Phone (515) 574-6890
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-050489 | IA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1518939693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 N 9TH ST",
"address_2": "SUITE A",
"city": "FORT DODGE",
"state": "IA",
"postal_code": "505013909",
"telephone_number": "515-574-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 15TH ST N",
"city": "HUMBOLDT",
"state": "IA",
"postal_code": "505481008",
"telephone_number": "515-332-2015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLOY",
"first_name": "SUE",
"middle_name": "A",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "A-050489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humboldt, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.