Kenneth Vondell Mallory

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN58728 Issued in DC

Practice address

501 School St SW Ste 200
Washington, DC 20024-2774

Phone

(703) 752-8700

NPI assigned

Aug 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Professional Healthcare Resources of Washington DC, Inc

  • Community Based Hospice Care Agency
  • Washington, DC
  • NPI 1922320076
  NPD (past)
• Professional Healthcare Resources of Washington DC, Inc.

  • Home Health Agency
  • Washington, DC
  • NPI 1497879910
  NPD (past)

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1982251187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 FAWLEY AVE",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207442124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SCHOOL ST SW STE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200242774",
            "telephone_number": "703-752-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "KENNETH",
        "middle_name": "VONDELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN58728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nada Mallick, MD
• Roudolphe Lepere Mallong Kombi
• Asia Mallory
• Bianca Mallory
• Katherine Olivia Mallory, M.D.
• Malik Mallory
• Nikia Mallory
• Olivia Jones Mallory
• Sharmane Mallory
• Shawnte Mallory

• All providers in Washington, DC
• Registered Nurse in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.