Mallory Shea Cooper Flanagan, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1113504 Issued in TX

Practice address

2965 Harrison St Ste 313
Beaumont, TX 77702-1113

Phone

(409) 838-4472

NPI assigned

Mar 17, 2023

Sex

Female

Sole proprietor

No

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Houston, TX
  • NPI 1679524961
  Medicare reassignment NPD
• Maxie C Sprott II MD PA

  • Specialist
  • Beaumont, TX
  • NPI 1326134594
  Medicare reassignment NPD
• Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Pasadena, TX
  • NPI 1609762889
  NPD

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1972204782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6090 NAVAJO TRL",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777083621",
            "telephone_number": "409-679-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 HARRISON ST STE 313",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021113",
            "telephone_number": "409-838-4472"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6090 Navajo Trl",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777083621",
            "country_code": "US",
            "telephone_number": "409-679-7029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "MALLORY",
        "middle_name": "SHEA COOPER",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-06-01",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "860470",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1113504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgett Fisk, NP
• Fitt Medical Clinic PLLC
• Jessica Fitzgerald, OTR/L
• Deborah Fitzhenry, MS, CCC-SLP
• Deauntae Flanagan
• Jillian Beth Fleisher, D.O.
• Michael Fleming, M.D.
• Amber Fling, ACNP
• Everardo Flores Jr., M.D.
• Georgiana Turk Flournoy, APRN, NP-C

• Family Nurse Practitioner in Beaumont, TX
• Providers in Beaumont, 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 Jun 1, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.