Mallory Blakeslee, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25885 Issued in MS

Practice address

4500 13TH St
Gulfport, MS 39501-2569

Phone

(228) 575-2000

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, MS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

William Carey University College of Osteopathic Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mblakeslee732108@directa.mercy.net

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.

• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment Care Compare group
• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297
  Medicare reassignment NPD
• Hospital Care Consultants Region II Inc

  • Internal Medicine Physician
  • West Memphis, AR
  • NPI 1558491449

  OK

  Medicare reassignment NPD
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD
• Relief LLC

  • Adult Medicine Physician
  • Long Beach, MS
  • NPI 1922821123
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Gulfport, MS
  • NPI 1043542772

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1053643791

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Radiation Oncology Physician
  • Gulfport, MS
  • NPI 1063663490

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Internal Medicine Physician
  • Gulfport, MS
  • NPI 1063744704

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093031494

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Wiggins, MS
  • NPI 1104477710

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Gastroenterology Physician
  • Gulfport, MS
  • NPI 1124311055

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Gulfport, MS
  • NPI 1184956815

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Gulfport, MS
  • NPI 1205129137

  Hospital

  Care Compare affiliation
• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  Care Compare affiliation

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1932516945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012569",
            "telephone_number": "228-575-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 13TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012569",
            "telephone_number": "228-575-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKESLEE",
        "first_name": "MALLORY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "52R",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "25885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lora Blades, RBT
• Leona Renea Blain
• Linsey Blain
• Vicki Arlene Blaize, LCSW
• Steven Parker Blakeney, DMD
• Virginia Arrington Blalack, MD
• Matthew Blanchard, MD
• Thomas Blanks, M.D.
• Ashley Blappert
• Bruce Thompson Bleil, D.M.D.

• Emergency Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.