DR ARENIA C MALLORY COMMUNITY HEALTH CENTER, INC
NPI 1053439133
Clinic/Center - Federally Qualified Health Center (FQHC) in Vaiden, MS
About Dr Arenia C Mallory Community Health Center, Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR ARENIA C MALLORY COMMUNITY HEALTH CENTER, INC (NPI 1053439133) is a healthcare organization registered as a federally qualified health center (fqhc) in Vaiden, Mississippi and active in the NPI registry since March 2007. The organization lists Dewery Montgomery, Interim Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr Arenia C Mallory Community Health Center, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Dr Arenia C Mallory Community Health Center, Inc, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (12)
Lexington, MS 39095
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mallory Community Health's NPI number?
The NPI number for Mallory Community Health is 1053439133. It was assigned to this organization in the NPPES registry on March 27, 2007. The provider is doing business as Dr Arenia C Mallory Community Health Center, Inc.
Where is Mallory Community Health located?
Mallory Community Health is located at 201A Magnolia St, Vaiden, MS 39176. The listed phone number is (662) 464-5470.
What is Mallory Community Health's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Mallory Community Health enrolled in Medicare?
Yes. Mallory Community Health is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mallory Community Health?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 4 Medicare specialties reassign their Medicare billing to Mallory Community Health. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (7), Family Practice (3) and Clinical Social Worker (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mallory Community Health was last updated on March 24, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr Arenia C Mallory Community Health Center, Inc · NPI 1053439133
Federally Qualified Health Center (FQHC) organization in Vaiden, Mississippi. Organization record, active in the CMS NPPES registry since March 27, 2007.
## Identity
- **NPI:** 1053439133 (Entity type: Organization)
- **Enumerated:** March 27, 2007
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Mallory Community Health
- **Organization subpart:** No
- **Authorized official:** Dewery Montgomery, INTERIM CEO
## Practice location
- **Address:** 201A MAGNOLIA ST, Vaiden, MS 39176-5644
- **Phone:** (662) 464-5470 · **Fax:** (662) 464-0152
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (7), Family Practice (3), Clinical Social Worker (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 24, 2014
- **Other identifiers:** Medicare OSCAR/certification 251880 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1053439133) · Data from the CMS NPPES public registry.