Mitchell Robert Mally, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

04853 Issued in IA

Practice address

3400 Dexter CT Ste 105
Davenport, IA 52807

Phone

(563) 823-5555

Fax

(563) 823-5556

NPI assigned

Aug 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tri-Med Health & Wellness Center, PC

  • Chiropractor
  • Davenport, IA
  • NPI 1336331339
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1790786358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DEXTER CT STE 105",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073462",
            "telephone_number": "563-823-5555",
            "fax_number": "563-823-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DEXTER CT STE 105",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52807",
            "telephone_number": "563-823-5555",
            "fax_number": "563-823-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLY",
        "first_name": "MITCHELL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "04853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1192278",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Main Street Health Partners, P.C.
• Melinda Sue Malchow, ARNP
• Ashu Malhotra, DDS
• Dennis P. Malik, D.C.
• Daniel Malloy
• Dipesh Kumar Mandal, M.D.
• Jonathan Douglas Manley, FNP-C
• Manor Care of Davenport Ia, LLC
• Manorcare Health Services, LLC
• Marisa Mansfield, LISW

• Chiropractor in Davenport, IA
• Providers in Davenport, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.