Mallory Mathis Carroll, PNP, FNP, MSN, RN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-185381 Issued in AL

Practice address

1600 7TH Ave S # Cppnm20
Birmingham, AL 35233-1711

Phone

(205) 638-9072

Fax

(205) 638-2833

NPI assigned

Jan 16, 2013

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 AL

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

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcarroll18689@childrensofalabama.direct-ci.com

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.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment NPD
• University of Alabama Health Services Foundation, PC

  dba UAHSF Department of Pediatrics

  • Pediatrics Physician
  • Birmingham, AL
  • NPI 1356377576
  NPD

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1639417215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S # CPPNM20",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-9072",
            "fax_number": "205-638-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S # CPPNM20",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-9072",
            "fax_number": "205-638-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MALLORY",
        "middle_name": "MATHIS",
        "name_prefix": "Mrs.",
        "credential": "PNP, FNP, MSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-185381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Benjamin Carroll
• Anthony Michael Carroll, PHARM.D.
• Caleb Carroll, MD
• Dylan Carroll, MS., BCBA
• Justin Taylor Carroll, CRNA
• Michael W. Carroll, CRNA
• Shannon L Carroll, MD
• Stephanie Carroll, PHARM.D.
• William R Carroll, MD
• Courtney Pratt Carruba, CRNA

• Pediatric Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.