Individual provider Active NPI

Mallory Stonehouse Sahr, NP

  • Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1962911206
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5410 Issued in MN
Practice address
671 Vandalia St
Saint Paul, MN 55114
Phone
(651) 698-2406
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5410 MN Primary

Addresses

Primary practice location

671 Vandalia St
Saint Paul, MN 55114

Mailing address

671 Vandalia St
Saint Paul, MN 55114-1312
Phone (651) 698-2406

Other names 1

  • Mallory Stonehouse Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20171211001500 MN Practitioner - Nurse Practitioner 4880952316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5410MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Minnesota, North Dakota, South Dakota CurrentSince Oct 15, 2018 Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota Past Accepting new patients
Planned Parenthood Minnesota, North Dakota, South Dakota Past Accepting new patients

Locations

700 Cedar St
Ste 165
Alexandria, MN 56308

15322 Galaxie Ave
Ste 105
Apple Valley, MN 55124
Phone (952) 890-0940

6900 78th Ave N
Ste 103
Brooklyn Park, MN 55445

1001 E Central Entrance
Ste 20
Duluth, MN 55811

1404 NW 4th St
Grand Rapids, MN 55744
Phone (218) 326-6689

91 Viking Dr W
Little Canada, MN 55117
Phone (651) 489-1328

201 N Victory Dr
Ste 211
Mankato, MN 56001
Phone (507) 387-5581

7532 Brooklyn Blvd
Minneapolis, MN 55443
Phone (763) 560-1555

1200 Lagoon Ave
Minneapolis, MN 55408
Phone (612) 823-6300

803 Belsly Blvd
Moorhead, MN 56560
Phone (218) 236-7145

6527 Lyndale Ave S
Richfield, MN 55423
Phone (612) 874-1420

1212 7th St NW
Rochester, MN 55901
Phone (507) 288-5186

451 E Saint Germain St
Ste 100
Saint Cloud, MN 56304
Phone (320) 252-9504

671 Vandalia St
Saint Paul, MN 55114
Phone (651) 696-5674

505 S 12th Ave W
Virginia, MN 55792
Phone (218) 749-2877

1795 Radio Dr
Ste D
Woodbury, MN 55125
Phone (651) 696-5550

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1962911206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 VANDALIA ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141312",
            "telephone_number": "651-698-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 VANDALIA ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55114",
            "telephone_number": "651-698-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONEHOUSE SAHR",
        "first_name": "MALLORY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "5410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "STONEHOUSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.