Hey, Find It
Hey, Find NPI

BRENDA SUSAN MALLORY M.D., NPI 1992707111

Physical Medicine & Rehabilitation in BLOOMINGTON, IN

Last Updated on : Sep 01,2020

About BRENDA SUSAN MALLORY (NPI 1992707111)


BRENDA SUSAN MALLORY is a Physical Medicine & Rehabilitation provider in BLOOMINGTON, United States. Her medical specialization is Physical Medicine & Rehabilitation .

1992707111 is NPI number of BRENDA SUSAN MALLORY.

BRENDA SUSAN MALLORY's primary taxonomy code based on NPI Lookup is 208100000X with license number 01084397A. This taxonomy code refers to Physical Medicine & Rehabilitation.

BRENDA SUSAN MALLORY has more than 16 years of experience.

BRENDA SUSAN MALLORY current practice location address is 601 W 2ND ST, BLOOMINGTON, IN. BRENDA SUSAN MALLORY can be reached out via phone at 812-353-6821 .

You can also correspond with BRENDA SUSAN MALLORY through mail at mailing address PO BOX 858, HERSHEY, PA, United States. Mailing address contact number is 800-243-1455.

The enumeration date of BRENDA SUSAN MALLORY is 01-Jun-2005. The provider is registered as an Individual and the NPI record was last updated 2 years ago.

1992707111 NPI Information

Name BRENDA SUSAN MALLORY
National Provider Id (NPI) 1992707111
Entity Type Individual
Gender F
Credential M.D.
Practice Address 601 W 2ND ST,
BLOOMINGTON, IN, United States
Practice Telephone 812-353-6821
Practice Fax Number
Mailing Address PO BOX 858 , MC A410
HERSHEY, PA, United States
Mailing Telephone 800-243-1455
Mailing Fax Number
Enumeration Date 01-Jun-2005
Last Updated Date 01-Sep-2020

BRENDA SUSAN MALLORY (NPI 1992707111) Primary Taxonomy Information

Primary Taxonomy Code Clasification License Number License State
Y 208100000X Physical Medicine & Rehabilitation 01084397A IN

BRENDA SUSAN MALLORY (NPI 1992707111) Secondary Taxonomy Information

Primary Taxonomy Code Clasification License Number License State
N 208100000X Physical Medicine & Rehabilitation MD440148 PA
N 208100000X Physical Medicine & Rehabilitation 191473-1 NY

Additional Identifiers

Identifier Type/Code Identifier State Identifier Issuer
01417674 MEDICAID (05) NY
1024982060001 MEDICAID (05) PA
191473-1 Other (non-Medicare) (01) NY NY State License
33H691 MEDICARE ID-Type Unspecified (04) NY
F03057 MEDICARE UPIN (02) NY

BRENDA SUSAN MALLORY (NPI 1992707111) Office Location

Providers in same location

NPI Name Taxonomy Address Enumeration date
1053884841 VIRGINA OLALDE Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
04-Jan-2019
1003964107 ALPESH K PATEL Dentist, General Practice 17644 VALLEY BLVD, UNITA # 1
BLOOMINGTON, CA, United States
08-Jan-2007
1033683123 NICHOLAS SMITH Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
11-Jan-2019
1437335619 LINDA HOON Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
17-Jan-2008
1386143881 DIMAS GIOVANNI CALVACHI Nurse Practitioner, Family 18601 VALLEY BLVD,
BLOOMINGTON, CA, United States
09-Feb-2018
1932646056 FREDDIE PHILLIP AVILA Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
26-Jan-2017
1629609938 TIMOTHY JUSTIN GOLDING Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
27-Jan-2020
1013055441 JAMES B ENTZ Marriage & Family Therapist 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
01-Feb-2007
1942765151 TAIWO OLANIKE ADAMS Nurse Practitioner, Family 18651 VALLEY BLVD,
BLOOMINGTON, CA, United States
01-Feb-2019
1720127210 CHELIE M MIDDLETON Registered Nurse 9774 OLIVE ST,
BLOOMINGTON, CA, United States
05-Feb-2007
1558600429 JOSE ORTIZ Dental Hygienist 11226 MEADOWLARK LN,
BLOOMINGTON, CA, United States
12-Feb-2013
1356482962 GENCIA MARGARIETTE WILLIAMS Marriage & Family Therapist 9961 SIERRA AVE,
FONTANA, CA, United States
08-Feb-2007
1568117067 JESSIE LEE HUBBS Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
14-Feb-2022
1467046359 JAMES RYAN DANIEL Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
22-Feb-2021
1487288387 SWETA R BABARIA Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
28-Feb-2020
1356975148 ETTIE LEE HOMES, INC Residential Treatment Facility, Emotionally Disturbed Children 160 E HOLT AVE STE B,
POMONA, CA, United States
02-Mar-2020
1326795147 DIEGO BOCANEGRA Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
02-Mar-2022
1346875093 KARINA M ACEVES Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
03-Mar-2020
1932379104 IVETTE CAROLINA RODRIGUEZ Case Manager/Care Coordinator 572 N ARROWHEAD AVE,
SAN BERNARDINO, CA, United States
04-Mar-2008
1487112926 SARAH SOSA Counselor, Addiction (Substance Use Disorder) 18612 SANTA ANA AVE,
BLOOMINGTON, CA, United States
04-Mar-2019

FAQs

Whose NPI Number is 1992707111?

1992707111 is the NPI number of BRENDA SUSAN MALLORY.

What is the specialty for BRENDA SUSAN MALLORY?

The Specialty of BRENDA SUSAN MALLORY is Physical Medicine & Rehabilitation.

NPI number meaning

Field Name Field Value
NPI 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code.
Provider Business Mailing Address Telephone Number The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider Business Practice Location Address Telephone Number The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number The fax number associated with the location address of the provider being identified.
Provider Enumeration Date The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date The date that a record was last updated or changed.
Authorized Official Telephone Number The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy Taxonomy Description of the Healthcare Provider.
Provider License Number Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Source : The information found on this website is provided "AS IS". It is in accordance with the NPPES Data Dissemination Notice, Freedom of Information Act (FOIA), and e-FOIA amendments. Kindly note that we do not guarantee the accuracy and/or reliability of the contents found on the website.