Individual provider Active NPI

Dana Elizabeth Mallory, MS, CCC-SLP, RN, BSN

  • Speech-Language Pathologist
  • Sherrills Ford, NC
National Provider Identifier
1669626156
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30003595 Issued in NC
Practice address
7120 Brookview LN
Sherrills Ford, NC 28673-9514
Phone
(845) 514-7793
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 607662-1 NY
Registered Nurse 163W00000X 376253 NC
Speech-Language Pathologist 235Z00000X 013221-1 NY
Speech-Language Pathologist 235Z00000X 30003595 NC Primary

Addresses

Primary practice location

7120 Brookview LN
Sherrills Ford, NC 28673-9514

Mailing address

7120 Brookview LN
Sherrills Ford, NC 28673-9514
Phone (845) 514-7793

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
Bachelor on Science - Nursing, Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
376253NCMDRegistered Nurse
607662-1NYMDRegistered Nurse
30003595NCMDSpeech-Language Pathologist
013221-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1669626156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 BROOKVIEW LN",
            "city": "SHERRILLS FORD",
            "state": "NC",
            "postal_code": "286739514",
            "telephone_number": "845-514-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 BROOKVIEW LN",
            "city": "SHERRILLS FORD",
            "state": "NC",
            "postal_code": "286739514",
            "telephone_number": "845-514-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "DANA",
        "middle_name": "ELIZABETH",
        "credential": "MS, CCC-SLP, RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "607662-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "376253",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "013221-1",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30003595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherrills Ford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2025; 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.