MALLORY SULLIVAN (NPI# 1124311360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124311360 |
| Entity Type | Individual |
| Full Name | MALLORY SULLIVAN |
| Credential | DO |
| Practice Address |
117 W Main St Suite 1 Waterville NY 13480-1165 |
| Practice Telephone | 3158414178 |
| Practice Fax Number | 3158414338 |
| Mailing Telephone | 3158414178 |
| Mailing Fax Number | 3158414338 |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2017-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 274601 | NY | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174013841 | Mallory Sullivan | Developmental Therapist | 1745 Hammonsville Jonesville Rd, Magnolia, KY 42757-7643 | 2018-05-17 |
| 1124663331 | Mallory Breanna Sullivan | Registered Nurse | 80 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3050 | 2019-11-12 |
| 1104219971 | Mallory Suzanne Sullivan | Counselor | 1101 Ball Ave Ne, Grand Rapids, MI 49505-5904 | 2015-03-18 |
| 1750689311 | Mallory Sullivan | Physician Assistant | 593 Eddy St, Providence, RI 02903-4923 | 2011-03-07 |
| Street Address |
117 W MAIN ST SUITE 1 |
| City | WATERVILLE |
| State | NY |
| Zip Code | 13480-1165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770584138 | Barbara L Jeffers | Family Medicine | 117 W Main St, Waterville, NY 13480-1165 | 2005-08-09 |
| 1427619139 | Cheryl Palmer | Nurse Practitioner | 117 W Main St, Waterville, NY 13480-1165 | 2019-06-24 |
| 1477080604 | Community Memorial Hospital | Family Medicine | 117 W Main St, Waterville, NY 13480-1165 | 2017-05-18 |
| 1770924391 | Jennifer Rogers | Nurse Practitioner | 117 W Main St, Waterville, NY 13480-1165 | 2013-07-11 |
| 1306931993 | Svetlana Bykovich | Nurse Practitioner | 117 W Main St, Waterville, NY 13480-1165 | 2006-10-03 |
| 1174514293 | Berit Nelson | Nurse Practitioner | 117 W Main St, Waterville, NY 13480-1165 | 2005-10-31 |
| 1912996273 | Francis E Chabot | Family Medicine | 117 W Main St, Waterville, NY 13480-1165 | 2005-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295366243 | The American People Services, Inc | Home Health | 7808 Route 20, Waterville, NY 13480 | 2020-01-29 |
| 1043303761 | Nannette S Cowen | Nurse Practitioner | 358 Madison St., Waterville, NY 13480 | 2006-10-02 |
| 1942854401 | Lara B Belfiore | Nurse Practitioner | 358 Madison St., Waterville, NY 13480 | 2019-08-01 |
| 1770078495 | Nicole R Schreck-mathias | Nurse Practitioner | 358 Madison St, Waterville, NY 13480 | 2018-06-25 |
| 1235384777 | Karen Alison Spencer | Occupational Therapist | 137 Berrill Ave, Waterville, NY 13480-1102 | 2008-11-25 |
| 1477728202 | Tracie F Preston | Licensed Practical Nurse | 135 Berrill Ave, Waterville, NY 13480-1102 | 2008-04-23 |
| 1750484598 | Cvs Albany, L.L.C. | Pharmacy | 139 E Main St, Waterville, NY 13480-1107 | 2006-09-07 |
| 1902924046 | Bartholomew Chiropractic PC | Chiropractor | 124 E Main St, 1st Floor, Waterville, NY 13480-1108 | 2007-03-27 |
| 1770552531 | Jeremy L Bartholomew | Chiropractor | 124 E Main St, Waterville, NY 13480-1108 | 2006-03-15 |
| 1255844940 | Chapman Chiropractic, Pllc | Chiropractor | 214 E Main St, Waterville, NY 13480-1110 | 2017-11-16 |
| Find all providers in zip 13480 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336671056 | Douglas Joseph Dicola | Family Medicine | Mainegeneral Medical Center, 149 North St, Waterville, ME 04901 | 2017-03-31 |
| 1184977704 | Wenatchee Valley Hospital | Family Medicine | 117 S. Chelan Ave., Waterville, WA 98858 | 2012-10-19 |
| 1083901078 | Alicia M Mancuso | Family Medicine | 16 Concourse W, Waterville, ME 04901-6007 | 2011-06-29 |
| 1184808453 | Steven B. Dood, M.d., LLC | Family Medicine | 140 South River Road, Waterville, OH 43566 | 2007-12-21 |
| 1255531257 | Linda Keniston | Family Medicine | 174 Kennedy Memorial Dr, Waterville, ME 04901-5134 | 2007-07-19 |
| 1417071127 | John Kent Bonney | Family Medicine | 16 Concourse West, Waterville, ME 04901 | 2007-03-19 |
| 1851448823 | Susan Marie Gurney | Family Medicine | 200 Kennedy Memorial Dr., Suite 304 Inland Hospital, Waterville, ME 04901 | 2007-01-04 |
| 1043370497 | A R Amalfitano, Do | Family Medicine | 94 Silver St, Waterville, ME 04901-5924 | 2006-12-08 |
| 1972663300 | William Bennett | Family Medicine | 325 Kennedy Memorial Dr # C, Waterville, ME 04901-4517 | 2006-12-08 |
| 1184721458 | Albert Raymond Amalfitano | Family Medicine | 94 Silver Street, Waterville, ME 04901 | 2006-09-20 |
| Find all providers in WATERVILLE | ||||
| City | WATERVILLE |
| Zip Code | 13480 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.