Individual provider Active NPI

Mallory Michelle Smith, M.D.

  • Infectious Disease Physician
  • North Little Rock, AR
National Provider Identifier
1831465384
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
E11562 Issued in AR
Practice address
2933 Lakewood Village Dr
North Little Rock, AR 72116-8033
Phone
(501) 435-1417
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E11562 AR
Infectious Disease Physician 207RI0200X E11562 AR Primary

Addresses

Primary practice location

2933 Lakewood Village Dr
North Little Rock, AR 72116-8033

Mailing address

PO Box 2650
Pine Bluff, AR 71613-2650
Phone (870) 541-7211

Other practice location 1

4747 Dusty Lake Dr Ste G1
Pine Bluff, AR 71603-9056
Phone (870) 541-7211

Other practice location 2

1420 W 43rd Ave Ste A
Pine Bluff, AR 71603-7010
Phone (870) 541-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20181127001631 AR Practitioner - Infectious DiseasePractitioner - Internal Medicine 7416240908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Oak Street Health Physicians Group of Arkansas PLLCGroup PAC ID 2264893411, 9 clinicians

Practice addresses (Care Compare)

2933 Lakewood Village Dr
North Little Rock, AR 72116-8033
Phone (501) 435-1417

Hospital & facility affiliations

  • Baptist Health Medical Center North Little Rock Hospital, North Little Rock, AR, CCN 040036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E11562ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health Physicians Group of Arkansas PLLC Internal Medicine CurrentSince Aug 19, 2024 Accepting new patients

Locations

5500 W 12th St
Little Rock, AR 72204
Phone (501) 435-1402

2933 Lakewood Village Dr
North Little Rock, AR 72116
Phone (501) 435-1417

Interoperability endpoints

  • Direct secure messaging: mallory.smith@oakstreethealth.gwaydirect.com

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1831465384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2650",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716132650",
            "telephone_number": "870-541-7211",
            "fax_number": "870-541-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 LAKEWOOD VILLAGE DR",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721168033",
            "telephone_number": "501-435-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4747 Dusty Lake Dr Ste G1",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716039056",
            "country_code": "US",
            "telephone_number": "870-541-7211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 W 43rd Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716037010",
            "country_code": "US",
            "telephone_number": "870-541-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MALLORY",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E11562",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AR",
            "license": "E11562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Little Rock, AR

Sources for this page

Verify at the official NPI Registry.