Individual provider Active NPI

Paul William Mallory, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Nashville, TN
National Provider Identifier
1790149821
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
61001 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-1554
Phone
(615) 322-3000
NPI assigned
Apr 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 61001 TN
Retina Specialist (Ophthalmology) Physician 207WX0107X 61001 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-1554

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (615) 936-2000

Other practice location 1

1400 W 22nd St
Sioux Falls, SD 57105-1554
Phone (605) 357-1386

Other identifiers 1

IdentifierTypeStateIssuer
61001OtherTNMEDICAL LICENSE - OPHTHALMOLOGY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmallory569651@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200714002595 TN Practitioner - Ophthalmology 6305130535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Sanford School of Medicine of University of South Dakota, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Eye Specialists PLLCGroup PAC ID 6800708504, 37 clinicians

Practice addresses (Care Compare)

7268 Jarnigan Rd
Suite 200
Chattanooga, TN 37421-3097
Phone 4235087337205

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.4 of 100Reported as group
Quality
76.44
Promoting interoperability
67
Improvement activities
40
Cost
72.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61001TNMDRetina Specialist (Ophthalmology) Physician
0312SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Eye Specialists PLLC Ophthalmology CurrentSince Jul 13, 2022 Accepting new patients
Southeast Eye Specialists PLLC Ophthalmology CurrentSince Jul 13, 2022 Accepting new patients

Locations

135 N Meadows Dr
Ste D
Athens, TN 37303
Phone 4235087337205

1609 Decatur Pike
Athens, TN 37303
Phone (423) 472-5401

135 N Meadows Dr
#A
Athens, TN 37303
Phone (423) 453-5314

7268 Jarnigan Rd
Ste 200
Chattanooga, TN 37421
Phone 4235087337289

2158 Northgate Park Ln
Ste 414
Chattanooga, TN 37415

7305 Jarnigan Rd
Ste 220
Chattanooga, TN 37421

4160 Ocoee St N
Ste 7
Cleveland, TN 37312
Phone 42350837737

195 White Oak Rd
Ste 300
Dayton, TN 37321
Phone (423) 332-8222

9453 Dayton Pike
Soddy Daisy, TN 37379
Phone (423) 332-8222

Interoperability endpoints

  • Direct secure messaging: pmallory569651@direct.vumc.org
  • Direct secure messaging: pmallory@southeasteye.intellechartdirect.net

Organizations & group practices 2

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 1

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1790149821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-936-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372321554",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W 22nd St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571051554",
            "country_code": "US",
            "telephone_number": "605-357-1386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "PAUL",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-05",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "61001",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TN",
            "license": "61001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE - OPHTHALMOLOGY",
            "identifier": "61001",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmallory569651@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372321554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.