Active NPI
Craig Mallory, PA-C
- Physician Assistant
- Southfield, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601008170
- Practice address
- 16001 W 9 Mile Rd
Southfield, MI 48075-4818 - Phone
- (248) 849-3137
- NPI assigned
- Apr 8, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601008170 | MI | Primary |
Addresses
Primary practice location
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Mailing address
PO Box 100
Royal Oak, MI 48068-0100
Phone (248) 849-3137
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
23455 Michigan Ave
Dearborn, MI 48124-1908
2446 Elizabeth Lake Rd
Waterford, MI 48328-3310
Phone (248) 309-3344
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Henry Ford Health St. John Hospital | Current | Accepting new patients | |
| Seton Health Corporation of Southeastern Michigan | Current | Accepting new patients | |
| Rochester Urgent Care, P. C. | Current | Accepting new patients | |
| Lakeside Urgent Care, P.C. | Current | Accepting new patients | |
| Somerset Urgent Care PLLC | Current | Accepting new patients | |
| First Choice Medical Group PLLC | Past | Accepting new patients | |
| Oxford Urgent Care, LLC | Past | Accepting new patients |
Locations
44472 Hayes Rd
Clinton Twp, MI 48038
Phone (586) 412-0890
22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248
1225 S Latson Rd
Ste 130
Howell, MI 48843
Phone (517) 338-2360
47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100
215 E Auburn Rd
Rochester Hills, MI 48307
Phone (248) 853-2009
2952 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 853-2009
74 S Elk St
Sandusky, MI 48471
Phone (810) 487-4676
22255 Greenfield Rd
Ste 550
Southfield, MI 48075
Phone (586) 226-6161
1500 W Big Beaver Rd
Ste 104
Troy, MI 48084
Phone (248) 649-4444
31200 Mound Rd
Warren, MI 48092
Phone (248) 850-8395
Interoperability endpoints
- https://api.platform.athenahealth.com/20203/brand/1/csg/1/fhir/r4
Organizations & group practices 23
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.
-
- Urgent Care Clinic/Center
- Dearborn, MI
- NPI 1629201264
-
- Urgent Care Clinic/Center
- Waterford, MI
- NPI 1538585260
-
- Urgent Care Clinic/Center
- Saint Clair Shores, MI
- NPI 1992442560
-
- Podiatrist
- Harrison Township, MI
- NPI 1043478910
-
- Urgent Care Clinic/Center
- Howell, MI
- NPI 1063124014
-
- Urgent Care Clinic/Center
- Novi, MI
- NPI 1689235897
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1780791343
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1700119500
-
- Urgent Care Clinic/Center
- Clinton Township, MI
- NPI 1720159304
-
- Urgent Care Clinic/Center
- Warren, MI
- NPI 1063159630
-
- Specialist
- Oxford, MI
- NPI 1700036936
-
- Urgent Care Clinic/Center
- Macomb, MI
- NPI 1184385791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491609600000",
"number": "1801329628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 100",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480680100",
"telephone_number": "248-849-3137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16001 W 9 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754818",
"telephone_number": "248-849-3137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLORY",
"first_name": "CRAIG",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-08",
"last_updated": "2017-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601008170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2017; 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.