Individual provider Active NPI

Mallory Katherine Hunt, CRNA

  • Certified Registered Nurse Anesthetist
  • Lakeland, FL
National Provider Identifier
1942762810
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11002199 Issued in FL
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X APRN11002199 FL Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190703002437 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143555649 Reassigns benefits to 1 organization
I20201202000101 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143555649 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Hospital & facility affiliations

  • Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN11002199FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP Single Specialty CurrentSince Oct 16, 2023 Accepting new patients
Sjmhs Anesthesia Services Single Specialty Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Nov 18, 2020 Accepting new patients
Sjmhs Anesthesia Services Single Specialty CurrentSince May 11, 2019 Accepting new patients
Sjmhs Anesthesia Services Single Specialty CurrentSince May 11, 2019 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Single Specialty CurrentSince Nov 18, 2020 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

850 111th Ave N
Naples, FL 34108
Phone (239) 596-2557

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

13060 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 972-4905

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

2006 Hogback Rd
Ste 5A
Ann Arbor, MI 48105
Phone (734) 786-2317

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1942762810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNT",
        "first_name": "MALLORY",
        "middle_name": "KATHERINE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11002199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.