Mallory Anne Mitchell, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

65573 Issued in TN

Practice address

6030 River Oaks Rd
Memphis, TN 38120-2547

Phone

(901) 338-5426

NPI assigned

May 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Uhs of Lakeside LLC

  • Psychiatric Hospital
  • Memphis, TN
  • NPI 1083687651
  Medicare reassignment NPD
• Alliance Healthcare Services

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1295898393
  Medicare reassignment
• Youth Villages, Inc.

  • Community/Behavioral Health Agency
  • Bartlett, TN
  • NPI 1306875695
  NPD (past)

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1720514003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 RIVER OAKS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202547",
            "telephone_number": "901-338-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 RIVER OAKS RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202547",
            "telephone_number": "901-338-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "MALLORY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TN",
            "license": "65573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jannie Yvonne Mitchell
• Jennifer Lee Mitchell
• John William Mitchell, LPC, MHSP
• Jonathan Randall Mitchell, PHARMD
• Kadean Alicia Mitchell
• Margaret Mitchell, MA, CCC-SLP
• Mark Mitchell, MD
• Mary Anne Mitchell
• Mary Chantay Mitchell, FNP-C
• Michael Francis Mitchell Jr., PA-C

• Child & Adolescent Psychiatry Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Child & Adolescent Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.