Mallory Middleton, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

206724 Issued in LA

Practice address

920 Oliver Rd
Monroe, LA 71201-5702

Phone

(318) 807-6263

Fax

(318) 812-7348

NPI assigned

Jul 1, 2019

Sex

Female

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

Enrolled in LA

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.

• Affinity Health Group, LLC

  • Family Medicine Physician
  • Monroe, LA
  • NPI 1023291226
  Medicare reassignment NPD
• Baton Rouge Clinic, a Medical Corporation

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1871546911
  Medicare reassignment NPD
• Affinity Health Group, LLC

  • Orthopaedic Surgery Physician
  • Monroe, LA
  • NPI 1861879249
  NPD
• Affinity Health Group, LLC

  • Family Medicine Physician
  • Monroe, LA
  • NPI 1922393024
  NPD
• Baton Rouge Clinic, a Medical Corporation

  • Ophthalmology Physician
  • Baton Rouge, LA
  • NPI 1528941655
  NPD

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1992367833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 DESIARD ST STE 355",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017363",
            "telephone_number": "318-807-7875",
            "fax_number": "318-812-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 OLIVER RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015702",
            "telephone_number": "318-807-6263",
            "fax_number": "318-812-7348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 S Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Rayville",
            "state": "LA",
            "postal_code": "712697684",
            "country_code": "US",
            "telephone_number": "318-557-9626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "MALLORY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "206724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Meyers, DO
• Owen Meredith Meyers, MD
• Michael Edward Boykin, M.D., a Medical Corporation
• Michael Hayward M.D. a Medical Corporation
• Timothy J Mickel, M.D., F.A.C.S.
• Midsouth Medical Inc
• Catherine L Midyett, FNP
• Ashley Miers, COTA
• Amethyst Miles
• Ashley Miles

• Pediatric Nurse Practitioner in Monroe, LA
• Providers in Monroe, LA by specialty
• Pediatric Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.