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MALLORY EVANS MD
NPI 1265122154
Student in an Organized Health Care Education/Training Program in Ann Arbor, MI

Active since May 12, 2023PECOS Enrolled
4260 PLYMOUTH RD, ANN ARBOR, MI 48109(734) 647-5670 Get Directions Write a Review

NPPES record last updated: May 12, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mallory Evans Md NPPES

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

MALLORY EVANS MD (NPI 1265122154) is an individual student in an organized health care education/training program in Ann Arbor, Michigan, licensed in Michigan (4351050575) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265122154
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMALLORY EVANSCredential: MD
Location Address4260 PLYMOUTH RDAnn Arbor, MI 48109-2700
Mailing Address1500 E Medical Center Dr Spc 5368Ann Arbor, MI 48109-5368
Phone(734) 647-5670
Sole ProprietorNo
Enumeration DateMay 12, 2023
NPPES CertifiedMay 12, 2023
✔ NPI 1265122154 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
License✔ Licensed in MI · 4351050575
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.
4260 PLYMOUTH RD, Ann Arbor, MI 48109
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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 Evans 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NINA K BIBICOFF NP
Nurse Practitioner
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 764-6831
KATHERINE SABER SALISBURY MD
Internal Medicine (Geriatric Medicine)
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 764-6831
ERIN KHANG LMSW
Social Worker (Clinical)
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 647-5655
REGENTS OF THE UNIVERSITY OF MICHIGAN
Audiologist
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 647-6591
MRS. MARIAM HASSAN REDA MD
Student in an Organized Health Care Education/Training Program
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 647-5680
VIKRAM GOVINDARAJU SHAKKOTTAI M.D.
Psychiatry & Neurology (Neurology)
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 764-6831
JENNY N HSU MD
Internal Medicine
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 647-5650
MRS. SARAH REPP PETERSON A.N.P.
Nurse Practitioner
4260 PLYMOUTH RD
ANN ARBOR, MI 48109
Washtenaw County (734) 763-6295

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 Evans's NPI number?

The NPI number for Mallory Evans is 1265122154. It was assigned to this individual provider in the NPPES registry on May 12, 2023.

Where is Mallory Evans located?

Mallory Evans practices at 4260 Plymouth Rd, Ann Arbor, MI 48109. The listed phone number is (734) 647-5670.

What is Mallory Evans'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 Evans enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mallory Evans was last updated on May 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.