Mallory Elizabeth Quesenberry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2020001927 Issued in MO

Practice address

3601 NE Ralph Powell Rd Ste C
Lees Summit, MO 64064-2316

Phone

(816) 285-5053

Fax

(816) 842-1974

NPI assigned

Dec 10, 2019

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clay Platte Family Medicine Clinic 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S Medical Center Hospital, Blue Springs, MO, CCN 260193

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Clay Platte Family Medicine Clinic

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1073570487

  MO

  Medicare reassignment Care Compare group
• Clay Platte Family Medicine Clinic

  • Durable Medical Equipment & Medical Supplies
  • Lees Summit, MO
  • NPI 1588138820
  NPD
• Missouri Em-I Medical Services, P.C.

  • Nurse Practitioner
  • Saint Louis, MO
  • NPI 1528008976
  NPD (past)
• Mo Cardinals Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1124454442
  NPD (past)

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

• Prime Healthcare Services Blue Springs, LLC

  • General Acute Care Hospital
  • Blue Springs, MO
  • NPI 1912303579

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1568009488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 NW 62ND TER STE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512412",
            "telephone_number": "816-842-4440",
            "fax_number": "816-842-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 NE RALPH POWELL RD STE C",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642316",
            "telephone_number": "816-285-5053",
            "fax_number": "816-842-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUESENBERRY",
        "first_name": "MALLORY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2020001927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren B Quaile, P.A.-C.
• Qualicare KC
• Ashley Qualls, RN, FNP-C
• Taylor D Qualls, MA
• Chase Victor Quattrocchi, DDS
• Quest Diagnostics Clinical Laboratories Inc
• Gloria Quick
• Megan Quick, PHARMD
• Sherry J Quick, RN, CPNP
• Jeffrey Rabideaux, PLPC

• All providers in Lees Summit, MO
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.