MALLORY LYNN PARK MSN, CRNP, FNP-C
NPI 1114755345
General Practice in Ridgway, PA
About Mallory Lynn Park Msn, Crnp, Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALLORY LYNN PARK MSN, CRNP, FNP-C (NPI 1114755345) is an individual general practice provider in Ridgway, Pennsylvania, licensed in Pennsylvania (SP030067) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, is affiliated with Penn Highlands Dubois, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mallory Lynn Park Msn, Crnp, Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Penn Highlands Dubois
Acute Care Hospitals · Dubois, PAPenn Highlands Elk
Critical Access Hospitals · Saint Marys, PAOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Park's NPI number?
The NPI number for Mallory Park is 1114755345. It was assigned to this individual provider in the NPPES registry on July 22, 2024.
Where is Mallory Park located?
Mallory Park practices at 250 W Main St, Ridgway, PA 15853. The listed phone number is (814) 772-8122.
What is Mallory Park's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Mallory Park enrolled in Medicare?
Yes. Mallory Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Mallory Park affiliated with any hospitals?
According to CMS data, Mallory Park is affiliated with Penn Highlands Dubois and Penn Highlands Elk.
When was this NPI record last updated?
The NPPES record for Mallory Park was last updated on July 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Mallory Lynn Park, MSN, CRNP, FNP-C · NPI 1114755345
General Practice physician in Ridgway, Pennsylvania. Individual provider, active in the CMS NPPES registry since July 22, 2024.
## Identity
- **NPI:** 1114755345 (Entity type: Individual)
- **Enumerated:** July 22, 2024
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** SP030067 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 250 W MAIN ST, Ridgway, PA 15853-1611
- **Phone:** (814) 772-8122
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** July 22, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1114755345) · Data from the CMS NPPES public registry.