Jacqueline A. Malloy, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 103102 Issued in GA

Practice address

101 Riverstone Vis
Blue Ridge, GA 30513-6648

Phone

(706) 258-4400

Fax

(706) 632-3585

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA, NM, TX4 enrollments

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 4

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spirit Care of Texas PCGroup PAC ID 6800338161, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Bsa Hospital Hospital, Amarillo, TX, CCN 450231

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Spirit Care of Texas PC

  • General Practice Physician
  • Amarillo, TX
  • NPI 1538928726

  Family

  Medicare reassignment Care Compare group NPD
• Choice Health, LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Albuquerque, NM
  • NPI 1245824663

  FL

  Medicare reassignment NPD
• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303
  Medicare reassignment
• Choice Health NM LLC

  • Nurse Practitioner
  • Albuquerque, NM
  • NPI 1346121910
  NPD
• Cartersville Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Cartersville, GA
  • NPI 1346295995
  NPD (past)
• Lavender Inpatient Services LLC

  • Internal Medicine Physician
  • Cartersville, GA
  • NPI 1902215767
  NPD (past)
• Mount Lassen Emergency Physicians LLC

  • Emergency Medicine Physician
  • Cartersville, GA
  • NPI 1730598590
  NPD (past)
• Strategic Georgia Physicians Group PC

  • Internal Medicine Physician
  • Buford, GA
  • NPI 1598474207

  Nurse Practitioner

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation
• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1861445447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 WATERFORD ESTATES MNR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301149422",
            "telephone_number": "770-704-1995",
            "fax_number": "706-632-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RIVERSTONE VIS",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305136648",
            "telephone_number": "706-258-4400",
            "fax_number": "706-632-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "JACQUELINE",
        "middle_name": "A.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9164727",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "80435",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1159783",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "ARNP 103102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samantha Lynn Markwis, RBT

• Family Nurse Practitioner in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.