Mallory Ann Chase, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12196 Issued in MN

Practice address

14451 Grand Ave
Burnsville, MN 55306-5708

Phone

(952) 993-5900

NPI assigned

Jun 8, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mallory Ann Phillips Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Clinic/Center
  • St Louis Park, MN
  • NPI 1275232423
  NPD (past)

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1871160937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14451 GRAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14451 GRAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065708",
            "telephone_number": "952-993-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2835 W Saint Germain St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563016281",
            "country_code": "US",
            "telephone_number": "320-259-4151",
            "fax_number": "320-259-5707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHASE",
        "first_name": "MALLORY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "PHILLIPS",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoriah Song Chang, NP
• Ontario Chapman
• Jessica Charis
• Dean Y. Charles, PSY.D.
• Adelaide J Charlton, WHNP
• Davina Vasentbhai Chauhan
• Mary Lisa Chedda, MA, LMFT
• Graceann Sarah Chelesvig
• Leland P Cheng, MD
• Wenlan Cheng, MD

• Physical Therapist in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.