Active NPI
Michael S Mallonee, MD
- Otolaryngology Physician
- Charlotte, NC
National Provider Identifier
1861461097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 24453
- Practice address
- 2325 W Arbors Dr
Suite 201
Charlotte, NC 28262-2663 - Phone
- (704) 295-3000
- Fax
- (704) 295-3468
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 24453 | NC | Primary |
Addresses
Primary practice location
2325 W Arbors Dr
Suite 201
Charlotte, NC 28262-2663
Mailing address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11545 | Other | NC | WELLPATH |
| 10474 | Other | NC | KANAWHA |
| N24453 | Medicaid | SC | |
| 000000293196 | Other | SC | UNISON HEALTH PLAN SC |
| 20097006 | Other | SC | SELECT HEALTH OF SC |
| 6194 | Other | NC | DOCTORS HEALTH PLAN |
| 01146098 | Other | SC | AMERIGROUP OF SC |
| 8953786 | Medicaid | NC | |
| 53743 | Other | NC | MEDCOST |
| 6354 | Other | NC | PARTNERS |
| 1041433 | Other | NC | UNITED HEALTHCARE |
| 141020 | Other | NC | COVENTRY HEALTHCARE |
| 276575 | Other | NC | MAMSI |
| 4066654 | Other | NC | AETNA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24453 | NC | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270771200000",
"number": "1861461097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2325 W ARBORS DR",
"address_2": "SUITE 201",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282622663",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLONEE",
"first_name": "MICHAEL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2010-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "24453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "11545",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANAWHA",
"identifier": "10474",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N24453",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON HEALTH PLAN SC",
"identifier": "000000293196",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "20097006",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOCTORS HEALTH PLAN",
"identifier": "6194",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP OF SC",
"identifier": "01146098",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8953786",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "53743",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "6354",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1041433",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY HEALTHCARE",
"identifier": "141020",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI",
"identifier": "276575",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4066654",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.