Individual provider Active NPI

James E Mallette III, D.O.

  • Specialist
  • Florence, AL
National Provider Identifier
1811965718
Registry record updated Oct 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
DO-749
Practice address
216 Marengo St
Suite H
Florence, AL 35630-6012
Phone
(256) 767-1701
Fax
(256) 760-0496
NPI assigned
Mar 8, 2006
Last updated
Oct 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X DO-749 Primary

Addresses

Primary practice location

216 Marengo St
Suite H
Florence, AL 35630-6012

Mailing address

216 Marengo St
Suite H
Florence, AL 35630-6012
Phone (256) 767-1701

Other identifiers 1

IdentifierTypeStateIssuer
009983860MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20111116000791 AL Practitioner - Allergy/Immunology 3375717978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Brody School of Medicine at East Carolina University, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

216 Marengo St
Suite H
Florence, AL 35630-6034
Phone (256) 767-1701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318204800000",
    "number": "1811965718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MARENGO ST",
            "address_2": "SUITE H",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356306012",
            "telephone_number": "256-767-1701",
            "fax_number": "256-760-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MARENGO ST",
            "address_2": "SUITE H",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356306012",
            "telephone_number": "256-767-1701",
            "fax_number": "256-760-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETTE",
        "first_name": "JAMES",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "DO-749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009983860",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.