Johntavis Lamar Mallary, PT in Fayetteville, NC - Medicare Physical Therapist Provider

Johntavis Lamar Mallary, PT is a medicare enrolled "Physical Therapist" provider in Fayetteville, North Carolina. His current practice location is 1991 Fordham Dr Ste 102, Fayetteville, North Carolina. You can reach out to his office (for appointments etc.) via phone at (910) 484-4653.

Johntavis Lamar Mallary is licensed to practice in North Carolina (license number P18256) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1932687886.

Contact Information

	Johntavis Lamar Mallary, PT
	1991 Fordham Dr Ste 102, Fayetteville, NC 28304-3774
	(910) 484-4653
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Johntavis Lamar Mallary
Gender	Male
Speciality	Physical Therapist
Location	1991 Fordham Dr Ste 102, Fayetteville, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932687886
Provider Enumeration Date: 08/02/2018
Last Update Date: 08/02/2018

Medicare PECOS Information:

PECOS PAC ID: 0042562951
Enrollment ID: I20181003003626

Medical Identifiers

Medical identifiers for Johntavis Lamar Mallary such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932687886	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	P18256 (North 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. Johntavis Lamar Mallary allows following entities to bill medicare on his behalf.

Provider Name	Fayetteville Orthopaedic Clinic Pa
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1417919390 PECOS PAC ID: 1355378167 Enrollment ID: O20050725000100

Provider Name	Manual Physical Therapy Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1164860169 PECOS PAC ID: 4385879592 Enrollment ID: O20131024000331

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. Johntavis Lamar Mallary 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
Johntavis Lamar Mallary, PT 1991 Fordham Dr Ste 102, Fayetteville, NC 28304-3774 Ph: (910) 484-4653	Johntavis Lamar Mallary, PT 1991 Fordham Dr Ste 102, Fayetteville, NC 28304-3774 Ph: (910) 484-4653

Reviews and Comments

Physical Therapist in Fayetteville, NC

Miss Roxanne King, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1700 Pamalee Drive, Fayetteville, NC 28303 Phone: 910-488-2295
Kristi Wilkins, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1289 Oliver St, Fayetteville, NC 28304 Phone: 910-483-8331 Fax: 910-483-8335
Dale Anthony Gallo Jr., DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4140 Ferncreek Dr Ste 802, Fayetteville, NC 28314 Phone: 910-484-2171 Fax: 910-484-4568
Michael Andrew Slack, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1712 Owen Dr, Fayetteville, NC 28304 Phone: 910-483-9300 Fax: 910-483-9302
Bridget Maley, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7532 Wilkins Dr, Fayetteville, NC 28311 Phone: 910-868-6000
Matthew Gregory Prindle, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 3401 Village Dr Ste 101, Fayetteville, NC 28304 Phone: 910-483-9300 Fax: 910-483-9302
Casandra Heather Canterbury, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 501 Executive Pl, Fayetteville, NC 28305 Phone: 910-423-5550 Fax: 910-423-5552

Johntavis Lamar Mallary, PT - Medicare Physical Therapist in Fayetteville, NC