Active NPI
Mallory Miles Speth, DC
- Chiropractor
- Cobb, WI
National Provider Identifier
1770116865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5482-12
- Practice address
- 109 Division St
Cobb, WI 53526-8501 - Phone
- (608) 723-7723
- NPI assigned
- Feb 17, 2020
- Last updated
- Nov 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5482-12 | WI | Primary |
Addresses
Primary practice location
109 Division St
Cobb, WI 53526-8501
Mailing address
109 Division St
Cobb, WI 53526-8501
Phone (608) 292-9440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5482-12 | WI | MD | Chiropractor |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Cobb, WI
- NPI 1477222925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1770116865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 DIVISION ST",
"city": "COBB",
"state": "WI",
"postal_code": "535268501",
"telephone_number": "608-292-9440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 DIVISION ST",
"city": "COBB",
"state": "WI",
"postal_code": "535268501",
"telephone_number": "608-723-7723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILES SPETH",
"first_name": "MALLORY",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-17",
"last_updated": "2023-11-08",
"certification_date": "2023-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WI",
"license": "5482-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cobb, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.