Individual provider Active NPI

Mallory Kaydee Eller-Leahy, DNP

  • Adult Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1629854914
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71015946A Issued in IN
Practice address
8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992
Phone
(317) 338-6666
NPI assigned
Sep 4, 2023
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71015946A IN Primary
Gerontology Nurse Practitioner 363LG0600X 71015946A IN
Registered Nurse 163W00000X 28240957A IN

Addresses

Primary practice location

8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992

Mailing address

8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992

Other practice location 1

537 Jefferson Ave
Indianapolis, IN 46201-2029
Phone (765) 480-2655

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mallory.eller.-.leahy.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20241203001705 IN Practitioner - Nurse Practitioner 8325573173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

8333 Naab Rd
Suite 420
Indianapolis, IN 46260-1992
Phone (317) 338-6666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71015946AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group, Inc. CurrentSince Jan 19, 2025 Accepting new patients
St. Vincent Medical Group, Inc. CurrentSince Jan 19, 2025 Accepting new patients
Major Hospital Past Accepting new patients
St Vincent Medical Group Inc Past Accepting new patients

Locations

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8333 Naab Rd
Ste 420
Indianapolis, IN 46260
Phone (317) 338-6666

8433 Harcourt Rd
Ste 100
Indianapolis, IN 46260
Phone (317) 583-7702

Interoperability endpoints

  • Direct secure messaging: mallory.eller.-.leahy.1@7598.direct.athenahealth.com

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

Hospital & facility affiliations 4

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": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1629854914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601992",
            "telephone_number": "317-338-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462012029",
            "country_code": "US",
            "telephone_number": "765-480-2655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLER-LEAHY",
        "first_name": "MALLORY",
        "middle_name": "KAYDEE",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71015946A",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71015946A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28240957A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mallory.eller.-.leahy.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "8333 Naab Rd Ste 420",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.