Individual provider Active NPI

Jessica Leigh Hammon-Mallory, PTA

  • Physical Therapy Assistant
  • Little Rock, AR
National Provider Identifier
1689183998
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
4225 Issued in AR
Practice address
1909 Hinson Loop Rd Ste 100
Little Rock, AR 72212-3903
Phone
(501) 301-4530
NPI assigned
Sep 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4225 AR Primary

Addresses

Primary practice location

1909 Hinson Loop Rd Ste 100
Little Rock, AR 72212-3903

Mailing address

1909 Hinson Loop Rd Ste 100
Little Rock, AR 72212-3903

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

State licenses

LicenseStateTypeSpecialty
4225ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Institute CurrentSince Jul 24, 2022 Accepting new patients

Locations

1909 Hinson Loop Rd
Ste 100
Little Rock, AR 72212
Phone (501) 563-9412

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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1689183998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 HINSON LOOP RD STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 HINSON LOOP RD STE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722123903",
            "telephone_number": "501-301-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMON-MALLORY",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-29",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "4225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.