Individual provider Active NPI

Julie Lynn Malloch, RN, IBCLC

  • Women's Health Nurse Practitioner
  • East Lansing, MI
National Provider Identifier
1750837845
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
4704285480 Issued in MI
Practice address
1560 Turf LN
East Lansing, MI 48823-6392
Phone
(517) 484-3000
Fax
(517) 484-6358
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 4704285480 MI
Women's Health Nurse Practitioner 363LW0102X 4704285480 MI Primary

Addresses

Primary practice location

1560 Turf LN
East Lansing, MI 48823-6392

Mailing address

1560 Turf LN
East Lansing, MI 48823-6392
Phone (517) 484-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL ww.alliance-obgyn.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191031001365 MI Practitioner - Nurse Practitioner 5597097170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uwh of Michigan PLCGroup PAC ID 0345626073, 91 clinicians

Practice addresses (Care Compare)

1560 Turf LN
East Lansing, MI 48823-6392
Phone (517) 484-3000

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704285480MIMDWomen's Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: julie.malloch.1@26060.direct.athenahealth.com

Organizations & group practices 1

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 2

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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1750837845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 TURF LN",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236392",
            "telephone_number": "517-484-3000",
            "fax_number": "517-484-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 TURF LN",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236392",
            "telephone_number": "517-484-3000",
            "fax_number": "517-484-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOCH",
        "first_name": "JULIE",
        "middle_name": "LYNN",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MI",
            "license": "4704285480",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704285480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ww.alliance-obgyn.com",
            "affiliation": "N",
            "address_1": "1560 Turf Ln",
            "city": "East Lansing",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488236392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.