Active NPI
Thomas A. Mallory, CRNA
- Certified Registered Nurse Anesthetist
- Montgomery, AL
National Provider Identifier
1699727875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 1-025137
- Practice address
- 470 Taylor Rd
Montgomery, AL 36117-3563 - Phone
- (334) 226-4048
- Fax
- (334) 323-5675
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 1-025137 | AL | Primary |
Addresses
Primary practice location
470 Taylor Rd
Montgomery, AL 36117-3563
Mailing address
2151 Old Rocky Ridge Road
Suite 106
Birmingham, AL 35216-7251
Phone (205) 989-1080
Other practice location 1
400 Taylor Rd
Montgomery, AL 36117
Phone (334) 277-8330
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051553683 | Medicaid | AL | |
| 051519076 | Other | AL | BLUE CROSS |
| 510-35357 | Other | AL | BCBS |
| 168012 | Medicaid | AL | |
| P01471421 | Other | AL | MEDICARE RR |
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
- Credentials
- Certified Registered Nurse
Interoperability endpoints
- thomas.mallory@direct.baptistfirst.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1699727875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 OLD ROCKY RIDGE ROAD",
"address_2": "SUITE 106",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352167251",
"telephone_number": "205-989-1080",
"fax_number": "205-989-1087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 TAYLOR RD",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361173563",
"telephone_number": "334-226-4048",
"fax_number": "334-323-5675"
}
],
"practiceLocations": [
{
"address_1": "400 Taylor Rd",
"address_purpose": "LOCATION",
"city": "Montgomery",
"state": "AL",
"postal_code": "36117",
"country_code": "US",
"telephone_number": "334-277-8330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALLORY",
"first_name": "THOMAS",
"middle_name": "A.",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AL",
"license": "1-025137",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "051553683",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "051519076",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "510-35357",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "168012",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P01471421",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.