Mallory Northcutt McCoy, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8206 Issued in SC

Practice address

1335 Kinard St
Newberry, SC 29108-3037

Phone

(803) 276-3367

Fax

(803) 276-6075

NPI assigned

Feb 12, 2013

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

Other names 1

• Dr. Mallory Jean Northcutt Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461801600000",
    "number": "1750620795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 MARGRAVE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292033945",
            "telephone_number": "843-858-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 KINARD ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291083037",
            "telephone_number": "803-276-3367",
            "fax_number": "803-276-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOY",
        "first_name": "MALLORY",
        "middle_name": "NORTHCUTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2016-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "NORTHCUTT",
            "middle_name": "JEAN",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Helen R Mason, MD
• Christine Davenport Matthews
• Shawanda Ratchford Matthews, PHARM.D.
• Robert P. McCartha, D.M.D.
• Chelsea Anthony McCoy, D.O
• Florence McCullough
• Candace McElveen
• Dipa McGee
• Becky Bedenbaugh McGlohorn
• Medical Park Dentistry

• Dentist in Newberry, SC
• Providers in Newberry, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; 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.