Individual provider Active NPI

Mallory Stewart Lott, ARNP

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1609397934
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9362485 Issued in FL
Practice address
10718 Countryway Blvd
Tampa, FL 33626-1733
Phone
(813) 844-4800
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9362485 FL Primary
Adult Health Nurse Practitioner 363LA2200X 9362485 FL

Addresses

Primary practice location

10718 Countryway Blvd
Tampa, FL 33626-1733

Mailing address

10718 Countryway Blvd
Tampa, FL 33626-1733
Phone (813) 844-4800

Other identifiers 1

IdentifierTypeStateIssuer
9362485OtherFLARNP

Other names 1

  • Mallory McKie Stewart Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlott149433@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20171127001577 FL Practitioner - Nurse Practitioner 0941567184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

10909 W Linebaugh Ave
Tampa, FL 33626-1741
Phone (813) 844-4800

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9362485FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Medical Group Inc CurrentSince Sep 24, 2018 Accepting new patients
Tampa General Hospital Current Accepting new patients
Tampa General Medical Group Inc Current Accepting new patients
Tampa General Medical Group Inc CurrentSince Sep 24, 2018 Accepting new patients

Locations

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

10909 W Linebaugh Ave
Tampa, FL 33626
Phone (813) 844-4800

Interoperability endpoints

  • Direct secure messaging: mlott149433@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1609397934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10718 COUNTRYWAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261733",
            "telephone_number": "813-844-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10718 COUNTRYWAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261733",
            "telephone_number": "813-844-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTT",
        "first_name": "MALLORY",
        "middle_name": "STEWART",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9362485",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "9362485",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP",
            "identifier": "9362485",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlott149433@direct.tgh.org",
            "affiliation": "N",
            "address_1": "10718 Countryway Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336261733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "STEWART",
            "middle_name": "MCKIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.