THERESA MALLORY (NPI# 1568431161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568431161 |
| Entity Type | Individual |
| Full Name | THERESA MALLORY |
| Credential | NP |
| Practice Address |
10 Willard Street Quincy MA 02169 |
| Practice Telephone | 6174791437 |
| Practice Fax Number | 6174793500 |
| Mailing Telephone | 6174791437 |
| Mailing Fax Number | 6174793500 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
128754 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 357472 | 05 | |
| MA | HPHC | N318 | 01 |
| MA | BC/BS | NP2083 | 01 |
| Street Address |
10 WILLARD STREET |
| City | QUINCY |
| State | MA |
| Zip Code | 02169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720263734 | Kayao Lau | Nurse Practitioner | 10 Willard Street, 1st Floor, Quincy, MA 02169-1281 | 2008-01-09 |
| 1619946142 | Shirley Shuster | Nurse Practitioner | 10 Willard Street, Quincy, MA 02169 | 2006-03-16 |
| 1689643108 | Gillian Serino | Nurse Practitioner | 10 Willard Street, Quincy, MA 02169 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154637973 | Compassionate Touch Healthcare Services, LLC | Nurse Practitioner | 1000 Strong Rd, Quincy, FL 32351-5249 | 2010-08-31 |
| 1639338049 | Donna Marie Slicis | Nurse Practitioner | 45 Hancock St, Apt 105, Quincy, MA 02171-1732 | 2008-06-02 |
| 1932284973 | Michelle Renee Miller | Nurse Practitioner | 185 E Chicago St, Quincy, MI 49082-1165 | 2006-10-26 |
| 1184647604 | Mary L Mckenney | Nurse Practitioner | 102 Pine St, Quincy, MA 02170-1208 | 2006-07-25 |
| 1942200324 | Jeanne C Benoit | Nurse Practitioner | 500 Congress St, Quincy, MA 02169-0908 | 2005-07-28 |
| 1861046070 | Diana M Veihl | Nurse Practitioner | 3301 Broadway, Quincy, IL 62301 | 2019-07-25 |
| 1386206795 | Luke A Ellerman | Nurse Practitioner | 1025 Maine St, Quincy, IL 62301-4038 | 2019-07-05 |
| 1124401377 | Sharon Olson | Nurse Practitioner | 936 Broadway St, Quincy, IL 62301-2731 | 2015-07-07 |
| 1316338932 | Rachel Killam | Nurse Practitioner | 927 Broadway St, Quincy, IL 62301-2719 | 2015-02-18 |
| 1205235462 | William O'shea | Nurse Practitioner | 110 W Squantum St, Quincy, MA 02171-2122 | 2014-08-13 |
| Find all providers in QUINCY | ||||
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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.