MALLORI TITTLE (NPI# 1982063749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1982063749 |
Entity Type | Individual |
Full Name | MALLORI TITTLE |
Credential | MS, ATC |
Practice Address |
6254 Warm Springs Rd Apt G6 Columbus GA 31909-9152 |
Practice Telephone | 7068871182 |
Mailing Telephone | 7068871182 |
Enumeration Date | 2016-02-22 |
Last Update Date | 2016-02-22 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171000000X | Military Health Care Provider | AT002401 | GA | Other Service Providers |
Street Address |
6254 WARM SPRINGS RD APT G6 |
City | COLUMBUS |
State | GA |
Zip Code | 31909-9152 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235747403 | Abundant Heart Healthcare Solution, LLC | Adult Companion | 6361 Talokas Lane, Ste C 140-279, Columbus, GA 31909 | 2020-07-14 |
1477185791 | Shandis Denise Phaneuf | Licensed Practical Nurse | 6545 Gregg Dr, Columbus, GA 31909 | 2020-02-05 |
1164086203 | Brock Musick | Physical Therapist | 100 First Court, Columbus, GA 31909 | 2019-04-24 |
1407340037 | Courtney Patterson | Behavior Technician | 5900 Warm Springs Road, Suite J, Columbus, GA 31909 | 2018-06-18 |
1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
1528577368 | Courtney Anne Young | Nurse Practitioner | 2700 Double Churches Rd, Apt 1207, Columbus, GA 31909 | 2017-09-25 |
1427573542 | Megan Renee Kwon | Dietitian, Registered | 4343 Warm Springs Road Apt. 110, Columbus, GA 31909 | 2017-08-09 |
1942659305 | Stephanie Mcghee | Dental Hygienist | 4835 Turnberry Lane, Columbus, GA 31909 | 2016-06-07 |
1770932162 | Tammy Allen | Dental Assistant | 701 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
1003265406 | Rhonda Mills | Dental Assistant | 7101 Hoff Rd Building 9240, Ft. Benning, GA 31909 | 2016-06-07 |
Find all providers in zip 31909 |
Taxonomy Code | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598962011 | Becky Anne Abell | Military Health Care Provider | 5462 Whittlesey Blvd Apt 1122, Columbus, GA 31909-3048 | 2007-06-28 |
1275625568 | Evelyn Jackson | Military Health Care Provider | 209 Miller Loop, Fort Benning, Columbus, GA 31905-6560 | 2006-09-28 |
1235771239 | Adam Lewis | Military Health Care Provider | 6600 Van Aalst Blvd, Columbus, GA 31905-2102 | 2019-10-10 |
1750477550 | Richard Gonzalez | Military Health Care Provider | 7950 Martin Loop, Fort Benning, Columbus, GA 31905 | 2006-10-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700425568 | Greggory Theotis Kent | Military Health Care Provider | 223 E Grady Ave, Lyons, GA 30436-1509 | 2019-12-26 |
1083142947 | Integrative Cap Health Practices | Military Health Care Provider | 770 Old Roswell Pl Ste G400, Roswell, GA 30076-8635 | 2017-05-23 |
1972037323 | Alicia Anderson | Military Health Care Provider | 621 Mcgruder St. Ne, Atlanta, GA 30312 | 2017-04-12 |
1508227141 | Compassion Community PCh LLC | Military Health Care Provider | 1942 Appling Harlem Rd, Appling, GA 30802-3723 | 2016-03-09 |
1902243876 | Victor D Parker IIi | Military Health Care Provider | 78th Medical Group Sghc, 655 Seventh Street, Robins Afb, GA 31098 | 2013-05-31 |
1235575325 | Gerardo Julian Soracco | Military Health Care Provider | 4415 Northside Chase Nw, Atlanta, GA 30327-3567 | 2013-05-15 |
1790023406 | Donna Sue Muller | Military Health Care Provider | 2715 Cosmos Dr Ne, Atlanta, GA 30345-1307 | 2013-01-30 |
1316298144 | Sandra Diane Tyree | Military Health Care Provider | 6490 Clyattstone Rd, Hahira, GA 31632-3112 | 2012-09-19 |
1558643536 | Eleanor S. Lee | Military Health Care Provider | 4211 Misty Morning Way, #2319, Gainesville, GA 30506-4347 | 2011-09-15 |
1073754891 | James Mercer Archer | Military Health Care Provider | 2450 Ruger Dr Ne, Marietta, GA 30066-1422 | 2009-03-09 |
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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.