Active NPI
Heather F Malloy
- Athletic Trainer
- Ruther Glen, VA
National Provider Identifier
1952984072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 810 Lake Caroline Dr
Ruther Glen, VA 22546-5315 - Phone
- (540) 645-8936
- NPI assigned
- May 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
810 Lake Caroline Dr
Ruther Glen, VA 22546-5315
Mailing address
810 Lake Caroline Dr
Ruther Glen, VA 22546-5315
Phone (540) 645-8936
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7578-7643-0457 | Other | NATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIANS | |
| 2000053207 | Other | ATC BOC NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1952984072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 LAKE CAROLINE DR",
"city": "RUTHER GLEN",
"state": "VA",
"postal_code": "225465315",
"telephone_number": "540-645-8936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 LAKE CAROLINE DR",
"city": "RUTHER GLEN",
"state": "VA",
"postal_code": "225465315",
"telephone_number": "540-645-8936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLOY",
"first_name": "HEATHER",
"middle_name": "F",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-05",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIANS",
"identifier": "7578-7643-0457",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATC BOC NUMBER",
"identifier": "2000053207",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Ruther Glen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.