Beth A. Mallare, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT003653 Issued in GA

Practice address

5671 Peachtree Dunwoody Rd NE
Suite 900
Atlanta, GA 30342-5000

Phone

(404) 531-8590

Fax

(404) 531-8581

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beth.mallare.1@15749.direct.athenahealth.com

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.

• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1386697928
  Medicare reassignment NPD
• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Braselton, GA
  • NPI 1033919790
  NPD

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1730144775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425000",
            "telephone_number": "404-531-8590",
            "fax_number": "404-531-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425000",
            "telephone_number": "404-531-8590",
            "fax_number": "404-531-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLARE",
        "first_name": "BETH",
        "middle_name": "A.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT003653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geethika Naga Malla, DO
• Prerana Malla, MD
• Shailesh Malla, MD
• Kylisha J Mallard, AA
• Laura W Mallard
• Jody Malleo, RD, LD, CDE
• Lillian Mallette, M.ED, NCC, APC
• Tarun Mallipeddi, MD
• Alexis Mallis
• Kristy Mallon

• Orthopedic Physical Therapist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.