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MALLORY ELIZABETH BLACKWOOD MD
NPI 1255071411
Student in an Organized Health Care Education/Training Program in Richmond, VA

Active since March 29, 2022PECOS Enrolled
309 S GASKINS RD, RICHMOND, VA 23238(804) 380-6162 Get Directions Write a Review

NPPES record last updated: March 29, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mallory Elizabeth Blackwood Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALLORY ELIZABETH BLACKWOOD MD (NPI 1255071411) is an individual student in an organized health care education/training program in Richmond, Virginia and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255071411
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMALLORY ELIZABETH BLACKWOODCredential: MD
Location Address309 S GASKINS RDRichmond, VA 23238-5707
Mailing Address309 S Gaskins RdRichmond, VA 23238-5707 · (804) 380-6162
Phone(804) 380-6162
Sole ProprietorNo
Enumeration DateMarch 29, 2022
NPPES CertifiedMarch 29, 2022
✔ NPI 1255071411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
309 S GASKINS RD, Richmond, VA 23238
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Elizabeth Blackwood Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Blackwood's NPI number?

The NPI number for Mallory Blackwood is 1255071411. It was assigned to this individual provider in the NPPES registry on March 29, 2022.

Where is Mallory Blackwood located?

Mallory Blackwood practices at 309 S Gaskins Rd, Richmond, VA 23238. The listed phone number is (804) 380-6162.

What is Mallory Blackwood's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mallory Blackwood enrolled in Medicare?

Yes. Mallory Blackwood is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mallory Blackwood was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.