Active NPI
Mallory Demott, RPH
- Pharmacist
- Tallahassee, FL
National Provider Identifier
1639623721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS55030
- Practice address
- 6615 Mahan Dr
Tallahassee, FL 32308-1400 - Phone
- (850) 878-5559
- NPI assigned
- Aug 7, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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.
-
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
-
- Community/Retail Pharmacy
- Tallahassee, FL
- NPI 1992744957
-
- Community/Retail Pharmacy
- Thomasville, GA
- NPI 1285886895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS55030 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets Inc | Past | Accepting new patients | |
| Publix Super Markets Inc | Past | Accepting new patients |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS55030 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
6615 Mahan Dr
Tallahassee, FL 32308-1400
Mailing address
13775 US Highway 19 S
Thomasville, GA 31792-5398
Phone (229) 228-6419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2023.
{
"created_epoch": "1470528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689984000000",
"number": "1639623721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13775 US HIGHWAY 19 S",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317925398",
"telephone_number": "229-228-6419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6615 MAHAN DR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323081400",
"telephone_number": "850-878-5559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMOTT",
"first_name": "MALLORY",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-07",
"last_updated": "2023-07-22",
"certification_date": "2023-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS55030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.