Mallory Washington, DNP, RN, CCRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

29568 Issued in TN

Practice address

848 Adams Ave
Memphis, TN 38103-2816

Phone

(901) 287-5437

NPI assigned

Jun 22, 2020

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Tennessee, HSC, College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ut Lebonheur Pediatric Specialists, Inc.Group PAC ID 7719173939, 162 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: mmascolo31141@mlh.direct-ci.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.

• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1801412283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 ISLAND HARBOR DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381038998",
            "telephone_number": "662-473-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 ADAMS AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032816",
            "telephone_number": "901-287-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, CCRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "220086",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "29568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Renee Washington, P.T.
• Chauniece Deshae Washington
• Darlene Maria Washington
• Gregory Washington, PHD, LCSW
• Lynette Washington, PHARMD
• Mary Bean Washington, MA,CCC-SLP
• Michael Jerome Washington, MD
• Mysti Washington, BCBA, LBA
• Pamela Washington, NP
• Secondria Monique Washington, FNP-C

• Pediatric Nurse Practitioner in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.