Individual provider Active NPI

Rosemary Mallonee

  • Emergency Medicine Physician
  • Gig Harbor, WA
National Provider Identifier
1720615461
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
61386542 Issued in WA
Practice address
11567 Canterwood Blvd
Gig Harbor, WA 98332-5812
Phone
(253) 530-2000
NPI assigned
Mar 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 61386542 WA Primary

Addresses

Primary practice location

11567 Canterwood Blvd
Gig Harbor, WA 98332-5812

Mailing address

11567 Canterwood Blvd
Gig Harbor, WA 98332-5812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20230830004242 WA Practitioner - Emergency Medicine 5597189530 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Virginia Tech Carilion School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

1615 Delaware St
Longview, WA 98632-2367
Phone (360) 414-2000

Hospital & facility affiliations

  • Peacehealth St John Medical Center Hospital, Longview, WA, CCN 500041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61386542WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Jul 16, 2023 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Northwest Observation Associates PC CurrentSince Jul 16, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

21601 76th Ave W
Edmonds, WA 98026
Phone (425) 640-4000

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

11567 Canterwood Blvd
Gig Harbor, WA 98332
Phone (253) 530-2000

1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

Interoperability endpoints

  • Direct secure messaging: rmallonee693840@direct.peacehealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1720615461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11567 CANTERWOOD BLVD",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11567 CANTERWOOD BLVD",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325812",
            "telephone_number": "253-530-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLONEE",
        "first_name": "ROSEMARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "61386542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

Verify at the official NPI Registry.