MALLORY MILLER (NPI# 1629475348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629475348 |
| Entity Type | Individual |
| Full Name | MALLORY MILLER |
| Credential | AG-ACNP |
| Practice Address |
620 Skyline Dr Jackson TN 38301-3923 |
| Mailing Address |
416 E Lafayette St Unit 304 Jackson TN 38301-6353 |
| Practice Telephone | 7315416900 |
| Mailing Telephone | 6158668044 |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2015-06-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 19221 | TN | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740685858 | Mallory L. Miller | Physician Assistant | 100 Radnor Rd Ste 101, State College, PA 16801 | 2014-10-31 |
| 1063036655 | Mallory Miller | Nurse Anesthetist, Certified Registered | 1600 7th Ave S, Birmingham, AL 35233-1711 | 2020-05-30 |
| 1912244385 | Mallory Nicole Miller | Physical Therapist | 7170 Carmel Valley Rd, Carmel, CA 93923-9525 | 2013-01-05 |
| Street Address |
620 SKYLINE DR |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821094608 | Julie A Mcbroom | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2005-06-25 |
| 1205440260 | Heather Middleton | Registered Nurse | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-09-06 |
| 1780297291 | Holly R Jones | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-08-25 |
| 1851909972 | Earl Wade Lomax | Student in an Organized Health Care Education/Training Program | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-07-15 |
| 1356960835 | Gregory Heath Mcneely | Registered Nurse | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-04-14 |
| 1174157515 | Matthew Lee Luttrell | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-02-25 |
| 1528698594 | Heidi Hill | Nurse Practitioner | 620 Skyline Dr, Jackson, TN 38301-3923 | 2020-01-18 |
| 1407406861 | Justin Harrison | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-09-18 |
| 1770131856 | Shelby Kathryn Berry | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-30 |
| 1891342028 | Jack Harold Fields IIi | Nurse Anesthetist, Certified Registered | 620 Skyline Dr, Jackson, TN 38301-3923 | 2019-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093265159 | Missouri Delta Medical Center | General Acute Care Hospital | 2856 Vista Ridge Pl, Jackson, MO 63755-8105 | 2016-10-12 |
| 1679810022 | Proficiency Scribes Cs, LLC | General Acute Care Hospital | 114 Bradley Rd, Jackson, GA 30233-3702 | 2013-01-04 |
| 1073588034 | Carelink of Jackson, A Community-owned Specialty Hospital | General Acute Care Hospital | 110 N. Elm Avenue, Jackson, MI 49202-3595 | 2006-02-22 |
| 1760921894 | University of Mississippi Medical Center | General Acute Care Hospital | 764 Lakeland Dr, 2nd Floor, Jackson, MS 39216-4651 | 2017-02-22 |
| 1861833535 | University Hospital | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2013-07-10 |
| 1730480120 | Mississippi Baptist Medical Center, Inc. | General Acute Care Hospital | 1225 N State St, Jackson, MS 39202-2064 | 2010-11-16 |
| 1497068639 | W.a. Foote Memorial Hospital | General Acute Care Hospital | 205 N East Ave, 7th Floor One Jackson Square, Jackson, MI 49201-1753 | 2010-07-16 |
| 1538472964 | The University of Mississippi Medical Center | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2010-07-14 |
| 1033349501 | University of Mississipi Medical Center | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2009-07-20 |
| 1447494323 | Sutter Valley Hospitals | General Acute Care Hospital | 200 Mission Blvd, Jackson, CA 95642-2564 | 2009-04-23 |
| Find all providers in JACKSON | ||||
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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.