Tammra Kay Mallory, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71007270A Issued in IN

Practice address

11027 Baycreek Dr
Indianapolis, IN 46236-9101

Phone

(813) 730-8960

NPI assigned

Aug 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 15

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN, IA, FL, MO, OH, KY, NY, NH, PA, WA11 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 11

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ivy Medical Group PLLCGroup PAC ID 4981097797, 120 clinicians

Dr Rebman Medical PAGroup PAC ID 3678087400, 88 clinicians

Daniel Funsch Jr MD PCGroup PAC ID 1951801836, 139 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Daniel Funsch Jr, M.D., P.C.

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1316784580

  FL

  Medicare reassignment Care Compare group NPD
• Dr Rebman Medical PA

  • Family Medicine Physician
  • Miami, FL
  • NPI 1669276689

  IL, IN, MO, NH, NY, OH, WA

  Medicare reassignment Care Compare group NPD
• Ivy Medical Group PLLC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1700558798

  FL, IL, KY, MO, NH, OH, PA, WA

  Medicare reassignment Care Compare group NPD
• Indiana University Health Urgent Care Centers, LLC.

  dba IU Health Urgent Care LLC

  • Urgent Care Clinic/Center
  • Greenwood, IN
  • NPI 1750763819
  Medicare reassignment NPD
• Paradigm Living Concepts, LLC

  • Gerontology Nurse Practitioner
  • Indianapolis, IN
  • NPI 1679194773
  Medicare reassignment NPD
• Dr Medical Services PC

  • Multi-Specialty Clinic/Center
  • New York, NY
  • NPI 1053012401

  FL, KY

  Medicare reassignment NPD
• Dr Rebman BH LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • New York, NY
  • NPI 1114894540

  FL, IL, IN, MO, NH, OH, WA

  Medicare reassignment NPD
• Indiana University Health Urgent Care Centers, LLC

  dba IU Health Urgent Care Centers, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1972273654
  NPD
• Paradigm Living Concepts, LLC

  dba Paradigm Health

  • Home Health Agency
  • Indianapolis, IN
  • NPI 1316370612
  NPD
• Paradigm Living Concepts, LLC

  dba Paradigm Health

  • Community Based Hospice Care Agency
  • Fort Wayne, IN
  • NPI 1669186334
  NPD

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1750757076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 3RD AVE FL 28",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224834",
            "telephone_number": "813-730-8960",
            "fax_number": "929-996-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11027 BAYCREEK DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462369101",
            "telephone_number": "813-730-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "TAMMRA",
        "middle_name": "KAY",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-20",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007270A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "28237767A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2023038564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "87047",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9497550",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10911",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "40452",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4008679",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-82580-082",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "358318",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "61654547",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14590-33",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A176453",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "116290-23",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013163",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Mallett
• Stasianne Mallin
• Andrew Mallory, PHARMD
• Courtney Lynn Mallory
• Emma Christine Mallory
• Timothy Mallory, LMFT-A
• Kari Sue Malloy, NP
• Leanne Foli Malloy, PH.D., HSPP
• William Xavier Malloy, M.S., PHARMD, BCPS
• Shilpa Ravi Mallur, MD

• Family Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.