Mallory Lynn O'Brien, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN233586 Issued in GA

Practice address

101 Bowens Mill Rd Ste H
Douglas, GA 31533-2252

Phone

(912) 384-3838

Fax

(912) 384-8847

NPI assigned

Mar 30, 2009

Sex

Female

Sole proprietor

Yes

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 GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Douglas Family Medicine Assoc

  • Family Medicine Physician
  • Douglas, GA
  • NPI 1508915687
  NPD (past)

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1639311178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BOWENS MILL RD STE H",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332252",
            "telephone_number": "912-384-3838",
            "fax_number": "912-384-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BOWENS MILL RD STE H",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332252",
            "telephone_number": "912-384-3838",
            "fax_number": "912-384-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 NW Bowens Mill Road",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315332252",
            "country_code": "US",
            "telephone_number": "912-384-3838",
            "fax_number": "912-384-4029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MALLORY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-30",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN233586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Dinh Nguyen, PHARMD
• Thaihang Nguyen, DO
• James Stephen Nobles, P.A.
• Katherine Joann Norris
• Walker Reid Nugent
• Stuart Jackson O'Steen, CRNA
• Elizabeth Olguin, MED CCC-SLP
• Open MRI of Douglas LLC
• Open MRI of Douglas LLC
• Orthopedic Surgeons of Georgia LLC (Orthopedic Surgeons of Georgia)

• Family Nurse Practitioner in Douglas, GA
• Providers in Douglas, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.