Mallory R. Waltrip, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209015762 Issued in IL

Practice address

900 N 1St St
Springfield, IL 62702-3749

Phone

(217) 528-7541

NPI assigned

Mar 16, 2017

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

• Mallory Rahar Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Springfield Clinic, LLPGroup PAC ID 0547166076, shared by 23 NPIs, 678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital Hospital, Litchfield, IL, CCN 141350
• Carlinville Area Hospital Hospital, Carlinville, IL, CCN 141347
• Abraham Lincoln Memorial Hospital Hospital, Lincoln, IL, CCN 141322
• Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as apm

Quality

75.65

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mallory.mckinnie.1@28977.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.

• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  Medicare reassignment NPD
• Springfield Clinic, LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1780638478
  Medicare reassignment NPD
• St Francis Hospital of the Hospital Sisters of the Third Order of St F

  • Critical Access Hospital
  • Litchfield, IL
  • NPI 1326057076
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Abraham Lincoln Memorial Hospital

  • Critical Access Hospital
  • Lincoln, IL
  • NPI 1154329753
  Care Compare affiliation
• Carlinville Area Hospital Association

  • Critical Access Hospital
  • Carlinville, IL
  • NPI 1053425124
  Care Compare affiliation
• Memorial Medical Center

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1255317590
  Care Compare affiliation
• St Francis Hospital of the Hospital Sisters of the Third Order of St F

  • Critical Access Hospital
  • Litchfield, IL
  • NPI 1326057076
  Care Compare affiliation

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1780125278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023749",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTRIP",
        "first_name": "MALLORY",
        "middle_name": "R.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209015762",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209015762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "RAHAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenna Walters, OTR/L
• Kaitlyn M Walters, MSN, WHNP-BC
• Walton Clinic of Chiropractic Inc
• Walton Clinic, LTD
• Adrian Paul Walton, DC
• Theresa Walz, P.T.A.
• Aiming Wang, CRNA
• Derek Wang, MD
• John Wang, DO
• Lin Wang, M.D.

• Gerontology Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.