Mallory Davis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP143336 Issued in TX

Practice address

5625 Eiger Rd Ste 200
Austin, TX 78735-8982

Phone

(512) 858-2997

NPI assigned

Oct 28, 2019

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

South Austin Family Practice Clinic, PLLCGroup PAC ID 3678564358, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mallory.davis.1@18292.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 and National Provider Directory roles.

• South Austin Family Practice Clinic, PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1235130592
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1942843438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358982",
            "telephone_number": "512-858-2997",
            "fax_number": "855-270-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358982",
            "telephone_number": "512-858-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MALLORY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lendol L. 'Tad' Davis, M.D.
• Lilly Davis, LPC-A
• Lisa Davis, L.P.C.
• Macy Davis, PA-C
• Maegan Davis, RD
• Meghan Ann Davis, AU.D., CCC-A
• Michael Stephen Davis, PA-C, M.S.
• Michelle Davis, PHD
• Miranda Joy Davis
• Nia Denise Davis

• Family Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.