DR. MALLORY C WHITLEY (NPI# 1861913592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861913592 |
| Entity Type | Individual |
| Full Name | DR. MALLORY C WHITLEY |
| Credential | MD |
| Practice Address |
2627 Riverside Ave Jacksonville FL 32204-4712 |
| Practice Telephone | (904) 308-7372 |
| Practice Fax Number | 9043082908 |
| Mailing Telephone | 9043087372 |
| Mailing Fax Number | 9043082908 |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2017-07-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | TRN25456 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
2627 RIVERSIDE AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770575052 | Belton Craig Ray | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4712 | 2005-08-22 |
| 1215549316 | Renee E Alten | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-08-19 |
| 1114538634 | Faradia Pierre | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-08-10 |
| 1841817772 | Kelsey Rhae Williams | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1477170488 | Lisa Michelle Alley | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1104443126 | Verniecea J Harris | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1508483421 | Lacey J Rokita | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1497372320 | Annika Tabassum | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1023635943 | Yvonne Nyakio Kamau | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1114542859 | Olivia Michelle Bullock | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528676186 | Sarah Colleen Tapscott | Family Medicine | 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 | 2020-07-20 |
| 1790303170 | Samantha L Scott | Family Medicine | 516 Pierce Ln, Jacksonville, TX 75766-4546 | 2020-07-11 |
| 1689298689 | Meridian Spine and Joint, Inc | Family Medicine | 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 | 2020-06-04 |
| 1154942563 | Families First Medical Group | Family Medicine | 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 | 2020-04-27 |
| 1598396392 | Pareto Population Health Management Practice Pllc | Family Medicine | 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 | 2020-01-30 |
| 1942862206 | Cindy S Wright Do Pllc | Family Medicine | 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 | 2019-07-07 |
| 1942868377 | Pain Spine & Wellness LLC | Family Medicine | 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 | 2019-05-31 |
| 1669035705 | Kathy Jo Daniels | Family Medicine | 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 | 2019-04-15 |
| 1821579103 | Tiffany N Major | Family Medicine | 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 | 2018-08-24 |
| 1568987360 | Main Street Health LLC | Family Medicine | 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 | 2017-08-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on DR. MALLORY C WHITLEY.
| 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.