Mallory Denmark Halterman, MHS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT005319 Issued in GA

Practice address

3648 Walton Way Ext
Augusta, GA 30909-6660

Phone

(706) 434-0799

NPI assigned

Sep 21, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Child Neurobehavioral Center for Health & Wellness, PC

  • Psychologist
  • Martinez, GA
  • NPI 1295898476
  NPD (past)

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1609159102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 BASTON RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309072906",
            "telephone_number": "706-447-8700",
            "fax_number": "706-447-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3648 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096660",
            "telephone_number": "706-434-0799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4116 Arkwright Rd",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312101707",
            "country_code": "US",
            "telephone_number": "478-477-0601",
            "fax_number": "973-965-4580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 Baston Rd",
            "address_purpose": "LOCATION",
            "city": "Martinez",
            "state": "GA",
            "postal_code": "309072906",
            "country_code": "US",
            "telephone_number": "706-447-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALTERMAN",
        "first_name": "MALLORY",
        "middle_name": "DENMARK",
        "credential": "MHS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT005319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan V Hall, MHS OTR/L
• Sarah Hall, RD, LD, CNSC
• Scotty Hall
• Stephanie Ann Hall, LMT, CPT
• Jason Andrew Halley, DO
• Reed Halterman
• Mureed Hamdani, DMD
• Emmanuel Hamelin, DO
• Donna Rybicki Hamill, RBT
• Benjamin H Hamilton, RPH

• Occupational Therapist in Augusta, GA
• Providers in Augusta, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.