Mallory Washington, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

232916 Issued in GA

Practice address

101 Yorktown Dr Ste 102
Fayetteville, GA 30214-1578

Phone

(770) 460-4285

NPI assigned

Jun 17, 2019

Last updated

Jun 17, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mallory.washington.2@8042.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD (past)
• Privia Pediatric Medical Group of Georgia LLC

  • Pediatrics Physician
  • Fayetteville, GA
  • NPI 1710385513
  NPD (past)

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1912567447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 SHAKERAG HILL STE 201",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694047",
            "telephone_number": "770-486-7111",
            "fax_number": "770-486-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 YORKTOWN DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141578",
            "telephone_number": "770-460-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "MALLORY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "232916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Ward, RBT
• Amy Warner, M.D.
• Amia Lynn Washington, NP
• Jennifer Washington, M.S.
• Malika Washington, LCSW
• Natasha Washington
• Yolanda Alfreda Washington, DPT
• Waterfall Emergency Physicians, LLC
• Waterfall Emergency Physicians, LLC
• Kashia Waterton, RBT

• Pediatric Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.