Mallory Kay Humphrey, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.0037747 Issued in OH

Practice address

600 W 3Rd St
Mansfield, OH 44906-2633

Phone

(419) 522-6191

NPI assigned

Dec 9, 2024

Last updated

Dec 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mallory Kay Weiss Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Ohio Medical University, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Third Street Community Clinic, Inc.Group PAC ID 2365423977, shared by 13 NPIs, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Third Street Community Clinic Inc

  dba Shelby Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Shelby, OH
  • NPI 1811364706
  Medicare reassignment NPD
• Third Street Community Clinic Inc

  dba Five Points Primary Care

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1972053452
  Medicare reassignment NPD
• Third Street Community Clinic, Inc

  dba Cline Avenue Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1720407554
  Medicare reassignment NPD
• Third Street Community Clinic, Inc.

  dba Malabar Care Connect

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1306499314
  Medicare reassignment NPD
• Third Street Community Clinic, Inc.

  dba Bucyrus Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Bucyrus, OH
  • NPI 1629620109
  Medicare reassignment NPD
• Third Street Community Clinic, Inc.

  dba Ashland Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Ashland, OH
  • NPI 1104461805
  NPD
• Third Street Community Clinic, Inc

  dba Cornerstone OB/GYN

  • Primary Care Clinic/Center
  • Mansfield, OH
  • NPI 1558576116
  NPD (past)

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

• Medcentral Health System

  • General Acute Care Hospital
  • Mansfield, OH
  • NPI 1790837235
  Care Compare affiliation
• Medcentral Health System

  dba Mansfield Laboratory Services

  • Clinical Medical Laboratory
  • Mansfield, OH
  • NPI 1962888016

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1982410528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 SUNSET BLVD",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072705",
            "telephone_number": "419-961-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 3RD ST",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449062633",
            "telephone_number": "419-522-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "MALLORY",
        "middle_name": "KAY",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0037747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "WEISS",
            "middle_name": "KAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shanay Nicole Hughes
• James L. Hull, P.T.
• Michael Justin Hull
• Timothy Hull, LPC
• Michelle Marie Huml, RN
• Kaylene M Hunt, LMT
• Kyleigh Michelle Hunt
• Morgan Hunt
• Virginia Hunt
• Karen K Hunter, OT

• Family Nurse Practitioner in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.
• 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.