Individual provider Active NPI

Mallory Flager, RDN

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1831890979
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN004683 Issued in PA
Practice address
833 Chestnut St FL 1
Philadelphia, PA 19107-4404
Phone
(215) 932-6165
NPI assigned
Mar 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN004683 PA Primary

Addresses

Primary practice location

833 Chestnut St FL 1
Philadelphia, PA 19107-4404

Mailing address

833 Chestnut St FL 1
Philadelphia, PA 19107-4404
Phone (215) 932-6165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240302000592 PA Practitioner - Registered Dietitian Or Nutrition Professional 5597100370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Univ of Pittsburgh School of Dental Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN004683PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians CurrentSince Jan 21, 2024 Accepting new patients
Jefferson University Physicians Past Accepting new patients

Locations

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-1085

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.

NPI Registry JSON

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1831890979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074404",
            "telephone_number": "215-932-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST FL 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074404",
            "telephone_number": "215-932-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAGER",
        "first_name": "MALLORY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN004683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.