Mallory Quinn Johnson, RN

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3015641 Issued in KY

Practice address

449 Kelso TRL
Corbin, KY 40701-8502

Phone

(606) 273-6971

NPI assigned

Sep 24, 2020

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Lincoln Memorial University Medical Department, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth Anesthesia, PSCGroup PAC ID 5092627521, 181 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph London Hospital, London, KY, CCN 180011

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjohnson391688@direct.stlukeshealth.org

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.

• Commonwealth Anesthesia, PSC

  • Anesthesiology Physician
  • Lexington, KY
  • NPI 1437196300

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Capital Anesthesia Solutions of Kentucky LLC

  • Anesthesiology Physician
  • Somerset, KY
  • NPI 1023665882

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

• Saint Joseph Health System, Inc

  dba CHI Saint Joseph London

  • Rural Acute Care Hospital
  • London, KY
  • NPI 1992701429
  Care Compare affiliation

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1972110815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 KELSO TRL",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018502",
            "telephone_number": "606-273-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 KELSO TRL",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018502",
            "telephone_number": "606-273-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MALLORY",
        "middle_name": "QUINN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3015641",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1129317",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R. Johnson, M.D.
• Katherine Johnson
• Kayla Danielle Johnson, BS
• Kori Johnson
• Leslie Marie Johnson, BA, QMRP
• Whitney Danielle Johnson, LPCC
• Aaron William Jones
• Anna Beth Jones, BS
• Caitlyn Jones
• Chelsea Leeann Jones, CCC-SLP

• Certified Registered Nurse Anesthetist in Corbin, KY
• Providers in Corbin, KY by specialty
• Certified Registered Nurse Anesthetist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.