Jonmeliah Mallory, is a medicare enrolled "Social Worker - Clinical" provider in St Johns, Florida. Her current practice location is
106 Ren Way, St Johns, Florida. You can reach out to her office (for appointments etc.) via phone at
(904) 325-4260.
Jonmeliah Mallory is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639712896.
Healthcare Provider's Profile
| Full Name | Jonmeliah Mallory |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 106 Ren Way, St Johns, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1639712896
- Provider Enumeration Date: 10/21/2019
- Last Update Date: 01/13/2025
Medicare PECOS Information:
- PECOS PAC ID: 0446794671
- Enrollment ID: I20240628002591
Medical Identifiers
Medical identifiers for Jonmeliah Mallory such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639712896 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | SW22218 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | 0904017115 (Virginia) | Secondary |
| 1041C0700X | Social Worker - Clinical | TLS1030CP (South Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jonmeliah Mallory allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20210414000053 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jonmeliah Mallory is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jonmeliah Mallory,
23 Rybar Ln,
Palm Coast, FL 32164-6445
Ph: (904) 325-4260 | Jonmeliah Mallory,
106 Ren Way,
St Johns, FL 32259-9407
Ph: (904) 325-4260 |
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