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DR. MALLORY DIANE LEWIS DO NPI 1588192520


NPI Information

NPI: 1588192520
Provider Name: DR. MALLORY DIANE LEWIS, DO
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: SACRED HEART HEALTH SYSTEM, INC.

PECOS Registration: Yes

Address:
3754 HIGHWAY 90 STE 300
PACE, FL
ZIP 32571
Phone: (850) 416-5510
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DR. Mallory Diane Lewis, DO is a family medicine in Pace, FL with 7 years of experience. The provider is 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. DR. Mallory Diane Lewis, DO NPI is 1588192520. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduation Year:2017

The provider's business location address is:

3754 HIGHWAY 90 STE 300
PACE, FL
ZIP 32571-098
Phone: (850) 416-5510

The NPI 1588192520 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2017 and was last updated on 9/13/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QS0010XFamily MedicineSports MedicineOS17878FLORIDANo
2207Q00000XFamily MedicineOS17878FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.