Mallory Pace

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4469 Issued in OK

Practice address

7020 NW 160TH St.
Edmond, OK 73013

Phone

(518) 477-0263

NPI assigned

Jan 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Village Physical Therapy, P.C.

  • Physical Therapist
  • Denver, CO
  • NPI 1083284194
  NPD
• Village Physical Therapy, P.C.

  • Physical Therapist
  • Denver, CO
  • NPI 1992465009
  NPD
• Village Physical Therapy, PC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1710026992
  NPD

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1548627771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 24TH ST APT 504",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052193",
            "telephone_number": "518-477-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 NW 160TH ST.",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "73013",
            "telephone_number": "518-477-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "MALLORY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "4469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Overgaard Services Inc.
• Demarcco Owens
• Peggy Owens, P.T., M.P.H.
• Veronica Ann Owens
• Gracelyn Oxford
• Jackson Paden, MSW
• Hanna E Padgett, PA-C
• Marissa Sky Page
• Narayana M Pai, M.D.
• Forrest William Paige

• Speech-Language Pathologist in Edmond, OK
• Providers in Edmond, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.