Active NPI
Mallory Dixon
- Physical Therapist
- Columbus, OH
National Provider Identifier
1861144396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 017010
- Practice address
- 1350 Alum Creek Dr
Columbus, OH 43209-2705 - Phone
- (614) 262-7520
- NPI assigned
- Jan 26, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 017010 | OH | Primary |
Addresses
Primary practice location
1350 Alum Creek Dr
Columbus, OH 43209-2705
Mailing address
1350 Alum Creek Dr
Columbus, OH 43209-2705
Other names 1
- Mallory Miller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017010 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643155200000",
"number": "1861144396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 ALUM CREEK DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432092705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 ALUM CREEK DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432092705",
"telephone_number": "614-262-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "MALLORY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-26",
"last_updated": "2022-01-26",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "017010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MALLORY",
"last_name": "MILLER",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.