MALLORY FORT (NPI# 1659707057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659707057 |
| Entity Type | Individual |
| Full Name | MALLORY FORT |
| Credential | P.N.P. |
| Practice Address |
1600 Nashville Hwy Columbia TN 38401-1004 |
| Practice Telephone | 9313888965 |
| Practice Fax Number | 9313880815 |
| Mailing Telephone | 9313888965 |
| Mailing Fax Number | 9313880815 |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
APN17959 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1600 NASHVILLE HWY |
| City | COLUMBIA |
| State | TN |
| Zip Code | 38401-1004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790748994 | Heather A Michalak | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401 | 2006-04-10 |
| 1326467028 | Laurie Tucker | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401-2069 | 2014-04-09 |
| 1720422017 | Megan Imboden Galaske | Pediatrics | 1600 Nashville Hwy, Ste 101, Columbia, TN 38401-2069 | 2013-04-17 |
| 1407146566 | Margaret A Atkins | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401-2069 | 2011-04-11 |
| 1053521401 | Richard P Smith | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401-1004 | 2007-05-23 |
| 1235251471 | Melanie Lord | Nurse Practitioner | 1600 Nashville Hwy, Columbia, TN 38401-1004 | 2007-04-06 |
| 1952411522 | Anthony Leon Smith | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401-1004 | 2006-08-30 |
| 1043320609 | Lori Natalie Duncan | Nurse Practitioner | 1600 Nashville Hwy, Columbia, TN 38401-1004 | 2006-08-30 |
| 1093825655 | Mary Overton | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401-1004 | 2006-08-30 |
| 1801906466 | Patricia Davis | Pediatrics | 1600 Nashville Hwy, Columbia, TN 38401-1004 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093327629 | Andrew Swensen | Pharmacist | 1202 South James Campbell Blvd, Columbia, TN 38401 | 2020-08-17 |
| 1790305522 | Milaya L Webster | Community Based Residential Treatment Facility, Mental Illness | 809 South Water Streer, Columbia, TN 38401 | 2020-04-22 |
| 1730729468 | Dania Cortez | Licensed Practical Nurse | 40 Park Plus Court, Columbia, TN 38401 | 2020-01-10 |
| 1619519683 | Agilitas Usa, Inc | Clinic/Center | 627 S. James Campbell Blvd., Suite B, Columbia, TN 38401 | 2019-10-11 |
| 1710531280 | Abby Graves | Dietitian, Registered | 1216 Trottwood Ave, Columbia, TN 38401 | 2019-08-01 |
| 1942771746 | James Brian Gregory | Marriage & Family Therapist | 497 E James Campbell Blvd, Columbia, TN 38401 | 2018-12-06 |
| 1104312255 | Sarah Miller | Social Worker | 230 E James Campbell Boulevard, Suite 113, Columbia, TN 38401 | 2018-07-02 |
| 1407343148 | Tammy Lynn James | Nurse Practitioner | 6011 Trotwood Ave Ste D, Columbia, TN 38401 | 2018-04-18 |
| 1053838276 | Tiffany Huskey | Audiologist-Hearing Aid Fitter | 1202 S James Campbell Blvd, Suite 15, Columbia, TN 38401 | 2017-08-28 |
| 1942726963 | Northland Hearing Center, Inc. | Hearing Aid Equipment | 1202 South James Campbell Blvd, Suite 15, Columbia, TN 38401 | 2017-08-22 |
| Find all providers in zip 38401 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093225096 | Edna Ayah | Nurse Practitioner | 8310 Guilford Rd, Columbia, MD 21046-1279 | 2017-10-04 |
| 1366995789 | Shawn Danielle Neyens | Nurse Practitioner | 303 N Keene St Ste 404, Columbia, MO 65201-7193 | 2016-08-02 |
| 1962823443 | Erin Gubbins | Nurse Practitioner | 500 N Keene St Ste 303, Columbia, MO 65201-8104 | 2013-12-30 |
| 1386924991 | Eleanor Doris Merboth | Nurse Practitioner | 6100 Dobbin Rd., Columbia, MD 21045 | 2011-08-26 |
| 1902986680 | Penelope Joan Buckman | Nurse Practitioner | 5 Medical Park Road, Columbia, SC 29203 | 2006-10-16 |
| 1952335077 | Karen Mae Waganer | Nurse Practitioner | 2113 Adams Grv Ste 101, Columbia, SC 29203-6957 | 2006-07-11 |
| 1740210129 | Laura L Szadek | Nurse Practitioner | Nine Medical Park, Suite 230, Columbia, SC 29203 | 2006-07-03 |
| 1104866771 | Elizabeth M Berg | Nurse Practitioner | 9 Richland Medical Park Dr Ste 500, Columbia, SC 29203-6870 | 2006-06-08 |
| 1871546226 | Sara G Fuller | Nurse Practitioner | 2638 Two Notch Rd, Suite 110, Columbia, SC 29204-1454 | 2006-05-18 |
| 1679531859 | Sara Margaret Haslag | Nurse Practitioner | 2011 Corona Rd, Suite 207, Columbia, MO 65203-2548 | 2006-05-03 |
| Find all providers in COLUMBIA | ||||
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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.