Mallory David, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95029041 Issued in CA

Practice address

23180 Hemlock Ave Ste 200
Moreno Valley, CA 92557-8001

Phone

(951) 221-3988

NPI assigned

Apr 24, 2024

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 CA

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moreno Valley Community Medical GroupGroup PAC ID 8224316203, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/27911/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/20715/brand/1/csg/1/fhir/r4
• Direct secure messaging: mallory.david.1@27911.direct.athenahealth.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.

• Moreno Valley Community Medical Group

  • Multi-Specialty Clinic/Center
  • Moreno Valley, CA
  • NPI 1437595873
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1639925399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916 S DEL NORTE AVE",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617009",
            "telephone_number": "323-304-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23180 HEMLOCK AVE STE 200",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925578001",
            "telephone_number": "951-221-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "MALLORY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Omran Darwish
• Hanaa Adnan Dauodi
• Amar Manglesh Dave, M.D.
• David Michael Scarpino Medical Services Inc
• David Reagan & Robert Smith DDS Smith Robert F Gen PTR.
• Lorece Sharnette Davis-Miller
• Carolyn Cherie Davis, NP
• Jacqueline Denise Davis
• Kasey Davis
• Lisa Davis, RPH

• Family Nurse Practitioner in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.