Mallory L Chambliss Odpa

Primary specialty

OptometristTaxonomy code 152W00000X

License

0793 Issued in NC

Legal business name

MALLORY L CHAMBLISS ODPA

Practice address

3320 Silas Creek Pkwy
Suite 150
Winston Salem, NC 27103-3031

Phone

(336) 760-4240

Fax

(336) 760-4240

NPI assigned

Mar 8, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mallory L Chambliss, OD

Title

President

Phone

(336) 760-4240

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sonja Ann Osborne, OPTICIAN

  • Optician
  • Winston Salem, NC
  • NPI 1235286360
  NPD (past)

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

{
    "created_epoch": "1204934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250640000000",
    "number": "1912177676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "RURAL HALL",
            "state": "NC",
            "postal_code": "270450279",
            "telephone_number": "336-760-4240",
            "fax_number": "336-760-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 SILAS CREEK PKWY",
            "address_2": "SUITE 150",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033031",
            "telephone_number": "336-760-4240",
            "fax_number": "336-760-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLORY L CHAMBLISS ODPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-08",
        "last_updated": "2009-08-19",
        "status": "A",
        "authorized_official_last_name": "CHAMBLISS",
        "authorized_official_first_name": "MALLORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-760-4240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09147",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909147",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sameeksha H Malhotra
• Ali Shaukat Malik, MD
• Devin Malik, LCSWA
• Mandeep Singh Malik, MD
• Catherine Elizabeth Malisse, MD
• Samantha Skye Mallory, RPA-C
• Emma Malmsten
• Alina Nykol Malone, NP
• William Malouf, MD
• Caitlin Ann Maloy, FNP-C

• Optometrist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.