Individual provider Active NPI

Mallory Elizabeth Alcala, DO

  • Pediatrics Physician
  • Forest City, NC
National Provider Identifier
1952894404
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021-00991 Issued in NC
Practice address
162 Commercial Dr Ste B
Forest City, NC 28043-2801
Phone
(828) 287-9325
NPI assigned
Jun 10, 2018
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 010055 GA
Pediatrics Physician 208000000X 2021-00991 NC Primary

Addresses

Primary practice location

162 Commercial Dr Ste B
Forest City, NC 28043-2801

Mailing address

162 Commercial Dr Ste B
Forest City, NC 28043-2801
Phone (828) 287-9325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210611000507 NC Practitioner - Pediatric Medicine 6204236334 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
010055GAMDPediatrics Physician
2021-00991NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Rutherford Physician Practices LLC CurrentSince Aug 1, 2021 Accepting new patients
DLP Rutherford Physician Practices LLC Pediatrics CurrentSince Aug 1, 2021 Accepting new patients

Locations

162 Commercial Dr
Ste B
Forest City, NC 28043
Phone (828) 286-5573

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: mallory.alcala.1@9573.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1528588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1952894404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 COMMERCIAL DR STE B",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280432801",
            "telephone_number": "828-287-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 COMMERCIAL DR STE B",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280432801",
            "telephone_number": "828-287-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCALA",
        "first_name": "MALLORY",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-10",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "010055",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2021-00991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

Verify at the official NPI Registry.