MALLORY JACOB WALSH (NPI# 1780151001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780151001 |
| Entity Type | Individual |
| Full Name | MALLORY JACOB WALSH |
| Practice Address |
100 Main St Apt 205 Pembroke NH 03275-1241 |
| Mailing Address |
111 New Hampshire Ave Ste 2 Portsmouth NH 03801-2864 |
| Practice Telephone | 8022748902 |
| Mailing Telephone | 6033194490 |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2019-04-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 363A00000X | Physician Assistant | 1466 | NH | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104481449 | Mallory Joy Uekman Walsh | Student in an Organized Health Care Education/Training Program | 920 Madison Ave Ste 447, Memphis, TN 38103-3438 | 2019-05-02 |
| 1497032932 | Mallory Walsh | Physician Assistant | 500 Martha Jefferson Dr, Charlottesville, VA 22911 | 2011-11-11 |
| Street Address |
100 MAIN ST APT 205 |
| City | PEMBROKE |
| State | NH |
| Zip Code | 03275-1241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386108710 | Great Brook Emergency Medical Services LLC | Ambulance | 340 Commerce Way, Pembroke, NH 03275 | 2019-01-30 |
| 1497284756 | Chantal Georgianna Filiau | Specialist/Technologist | 431 Micol Rd., Pembroke, NH 03275 | 2017-06-08 |
| 1215242714 | Guy Edward Croasdale | Pharmacist | 46 Allenstown Rd, Allenstown, NH 03275 | 2010-08-10 |
| 1679758965 | Joyce Ann Pollinger | Counselor | 133 River Rd., Alenstown, NH 03275 | 2008-01-04 |
| 1649492265 | Spectrum Lifecare Services | Durable Medical Equipment & Medical Supplies | 626 B Buck St, Pembroke, NH 03275 | 2007-05-03 |
| 1275551053 | Vincent Emil Greco | Chiropractor | 210 Pembroke Street, Pembroke, NH 03275 | 2006-07-18 |
| 1770893406 | Tri-town Family Dental LLC | Dentist | 50 Pinewood Rd, Allenstown, NH 03275 | 2010-10-15 |
| 1770795858 | Fredrick M. Vega, D.d.s., P.C. | Clinic/Center | 50 Pinewood Road, Allenstown, NH 03275 | 2007-05-03 |
| 1437228863 | Charles E. Albee, Dmd, Pa Suncook Family Dentistry | Dentist | 119 Pembroke St, Suncook, NH 03275 | 2006-11-07 |
| 1942864806 | Affinity Care Nh, LLC | Home Health Aide | 15 Pine St, Pembroke, NH 03275-1132 | 2019-04-26 |
| Find all providers in zip 03275 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811464415 | Teresa Mariam Fatemi | Physician Assistant | 124 Pilgrim Rd, Pembroke, MA 02359-1940 | 2018-11-01 |
| 1477000735 | Elizabeth Locklear | Physician Assistant | 498 Whistling Rufus Rd, Pembroke, NC 28372-8380 | 2016-09-04 |
| 1578887568 | Coy Watkins | Physician Assistant | 244 Ledford St 1188, Pembroke, GA 31321-1188 | 2010-03-18 |
| 1205476165 | Kayla Jacobs | Physician Assistant | 812 Candy Park Rd, Pembroke, NC 28372-9120 | 2020-01-08 |
| 1902363153 | Karen Rose Betz | Physician Assistant | 102 Livermore Dr, Pembroke, NC 28372-7270 | 2019-02-25 |
| 1689172868 | Tyler Elliott Dial | Physician Assistant | 923 W 3rd St, Pembroke, NC 28372-9628 | 2018-01-23 |
| 1295180206 | Cari Susann Mayers | Physician Assistant | 307 E Wardell Dr, Pembroke, NC 28372 | 2016-04-27 |
| 1144609595 | Cynthia Anne Tranchemontagne | Physician Assistant | 121 Pembroke St, Pembroke, NH 03275-1311 | 2015-05-19 |
| 1669720736 | Kimberly Elizabeth Lennox | Physician Assistant | 28 Riverside Dr, Pembroke, MA 02359 | 2012-08-21 |
| 1467767053 | Suzette Renee Oxendine | Physician Assistant | 307 E Wardell Dr, Pembroke, NC 28372-7998 | 2010-08-09 |
| Find all providers in PEMBROKE | ||||
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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.