Mallory Jackson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA065306 Issued in PA

Practice address

6 N Dorcas St
Lewistown, PA 17044-1737

Phone

(717) 953-9571

NPI assigned

Jan 4, 2024

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

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Nitin V Sheth MD LLCGroup PAC ID 0143405134, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Nitin V Sheth MD LLC

  • Adult Mental Health Clinic/Center
  • Lewistown, PA
  • NPI 1124324017
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1704326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1871363556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10086 NANCY DR",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163356322",
            "telephone_number": "814-547-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 N DORCAS ST",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441737",
            "telephone_number": "717-953-9571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10086 Nancy Dr",
            "address_purpose": "LOCATION",
            "city": "Meadville",
            "state": "PA",
            "postal_code": "163356322",
            "country_code": "US",
            "telephone_number": "814-547-8555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "MALLORY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-04",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Oakley Huston, RN
• Michael James Hutton, OD
• Patti Lynn Hutton, LPC
• Austin James Iovoli, MD
• J & D'S, Inc.
• Janay Patrice January
• Karolyn Jenkins, MSPT
• Jerry E. Boyer, PH.D., P.C.
• Kathryn Louise Jeziorski, CNM
• Zhaohan Jia

• Physician Assistant in Lewistown, PA
• Providers in Lewistown, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.