Mrs Mallory Smith, NP is a medicare enrolled "Nurse Practitioner - Primary Care" in Pinewood, South Carolina. Her current practice location is
25 E Clark St, Pinewood, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 774-4501.
Mrs Mallory Smith is licensed to practice in South Carolina (license number 26148) 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 1003533357.
Provider's Profile
| Full Name | Mrs Mallory Smith |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Primary Care |
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| Location | 25 E Clark St, Pinewood, South Carolina |
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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: 1003533357
- Provider Enumeration Date: 10/26/2022
- Last Update Date: 10/26/2022
Medicare PECOS Information:
- PECOS PAC ID: 9436521390
- Enrollment ID: I20230202002696
Medical Identifiers
Medical identifiers for Mrs Mallory Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003533357 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP2300X | Nurse Practitioner - Primary Care | 26148 (South Carolina) | 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. Mrs Mallory Smith allows following entities to bill medicare on her behalf.
| Entity Name | Tandem Health Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386630192
PECOS PAC ID: 3870575855
Enrollment ID: O20040603000514 |
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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. Mrs Mallory Smith 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 |
|---|
Mrs Mallory Smith, NP
25 E Clark St,
Pinewood, SC 29125-8989
Ph: (803) 774-4501 | Mrs Mallory Smith, NP
25 E Clark St,
Pinewood, SC 29125-8989
Ph: (803) 774-4501 |
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