Mallory Hertz

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1919 Issued in SD

Practice address

101 Tower Rd
Suite 110
Dakota Dunes, SD 57049-5011

Phone

(605) 217-4330

NPI assigned

Sep 1, 2016

Last updated

Sep 1, 2016By the provider in NPPES

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 SD, IA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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

• Ear Nose and Throat Consultants and Hearing Services PLC

  • Otolaryngology Physician
  • Dakota Dunes, SD
  • NPI 1114141546

  IA

  Medicare reassignment NPD
• Ear Nose and Throat Consultants

  dba Fyzical

  • Specialist
  • Dakota Dunes, SD
  • NPI 1649629957
  NPD (past)
• Allergy, Asthma & Immunology Associates P.C.

  • Allergy & Immunology Physician
  • Omaha, NE
  • NPI 1063471860
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1578019212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 TOWER RD",
            "address_2": "SUITE 110",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495011",
            "telephone_number": "605-217-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 TOWER RD",
            "address_2": "SUITE 110",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495011",
            "telephone_number": "605-217-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERTZ",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "1919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hawkeye Clinic of South Dakota PLLC (Dunes Eye Consultants)
• Mei He, M.D.
• James Ronald Hegvik, MD
• Jeff Hemmingsen, DDS
• Thomas W Hepperlen, M.D.
• Shauna Meghan Hoak, MPT
• Joshua Hockett
• Brandon John Hofland, NURSE PRACTITIONER
• Kimberly Ann Hokinson, ARNP, FNP-C
• Heather E Holbrook, DPT

• Physical Therapist in Dakota Dunes, SD
• Providers in Dakota Dunes, SD by specialty
• Physical Therapist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.