Individual provider Active NPI

Mallory Scroggins, MOT

  • Occupational Therapist
  • Alton, IL
National Provider Identifier
1649925033
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1719 Clawson St
Alton, IL 62002-4702
Phone
(217) 409-6405
Fax
(618) 462-1133
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1719 Clawson St
Alton, IL 62002-4702

Mailing address

1719 Clawson St
Alton, IL 62002-4702
Phone (217) 409-6405

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alton Physical Therapy, P.C. CurrentSince Feb 1, 2022 Accepting new patients

Locations

1719 Clawson St
Alton, IL 62002
Phone (618) 462-1133

3550 College Ave
Alton, IL 62002
Phone (618) 462-1133

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1649925033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 CLAWSON ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024702",
            "telephone_number": "217-409-6405",
            "fax_number": "618-462-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 CLAWSON ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024702",
            "telephone_number": "217-409-6405",
            "fax_number": "618-462-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCROGGINS",
        "first_name": "MALLORY",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.