Stasianne Mallin

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

635 Barnhill Dr RM 112
Indianapolis, IN 46202-5126

Phone

(317) 274-3772

NPI assigned

Jul 8, 2024

Last updated

Jul 24, 2024By 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

Enrolled in TN

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 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1942046925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 BARNHILL DR RM 112",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025126",
            "telephone_number": "317-274-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BARNHILL DR RM 112",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025126",
            "telephone_number": "317-274-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIN",
        "first_name": "STASIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Ann Malkoff
• Fred S Malkowski, DDS
• Sara Mallams, MS OTR/L
• Michael Mallari
• Whitney Mallett
• Andrew Mallory, PHARMD
• Courtney Lynn Mallory
• Emma Christine Mallory
• Tammra Kay Mallory, FNP-C
• Timothy Mallory, LMFT-A

• Student in an Organized Health Care Education/Training Program in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.