MALLORY THURMOND CRNP
NPI 1366391179
Nurse Practitioner in Philadelphia, PA

Q: What is Mallory Thurmond's NPI number?

The NPI number for Mallory Thurmond is 1366391179. It was assigned to this individual provider in the NPPES registry on January 26, 2026.

Q: What is Mallory Thurmond's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Mallory Thurmond was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.

Active since January 26, 2026PECOS EnrolledAccepts Medicare Assignment

333 COTTMAN AVE, PHILADELPHIA, PA 19111(215) 728-2570(215) 728-3639 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 11, 2026, Jan 26, 2026 (2 updates tracked since 2026).

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About Mallory Thurmond Crnp NPPES

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

MALLORY THURMOND CRNP (NPI 1366391179) is an individual nurse practitioner in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP034280) and active in the NPI registry since January 2026. She is enrolled in Medicare PECOS and is a graduate of Baylor College Of Medicine (2025).

NPPES Registry Identity

NPI1366391179

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMALLORY THURMONDCredential: CRNP

Location Address333 COTTMAN AVEPhiladelphia, PA 19111-2434

Mailing Address3509 N Broad StPhiladelphia, PA 19140-4105 · (215) 707-3911

Phone(215) 728-2570

Fax(215) 728-3639

Sole ProprietorNo

Medical School CMSBaylor College Of MedicineGraduated 2025

Enumeration DateJanuary 26, 2026

Last NPPES UpdateMay 11, 20262 updates tracked since enumeration

NPPES CertifiedMay 11, 2026

✔ NPI 1366391179 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in PA · SP034280

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

333 COTTMAN AVE, Philadelphia, PA 19111

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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 and accepts Medicare assignment

Mallory Thurmond Crnp 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.

PECOS PAC ID6608347158

PECOS Enrollment IDI20260604003747

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19111 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

FOX CHASE CANCER CENTER MEDICAL GROUP, INC.

Anesthesiology

333 COTTMAN AVE, MED STAFF OFFICE
PHILADELPHIA, PA 19111

Philadelphia County (215) 728-6900

JAMES SUN MD

Surgery (Surgical Oncology)

333 COTTMAN AVE
PHILADELPHIA, PA 19111

Philadelphia County (215) 854-9799

MS. MALA T KAILASAM MD

Internal Medicine

333 COTTMAN AVE, FOX CHASE CANCER CENTER
PHILADELPHIA, PA 19111

Philadelphia County (215) 728-6900

HEALTH SERVICES OF FOX CHASE CANCER CTR.

Radiology (Diagnostic Radiology)

333 COTTMAN AVE, RADIOLOGY ASSOCIATES OF FCCC
PHILADELPHIA, PA 19111

Philadelphia County (215) 728-6900

ELENA DREYZIN PA-C

Physician Assistant

333 COTTMAN AVE
PHILADELPHIA, PA 19111

Philadelphia County (888) 369-2427

FREWEINI TESFALEDET PA

Physician Assistant

333 COTTMAN AVE
PHILADELPHIA, PA 19111

Philadelphia County (215) 728-6900

MARIUSZ A WASIK MD

Pathology (Anatomic Pathology)

333 COTTMAN AVE
PHILADELPHIA, PA 19111

Philadelphia County (215) 728-3675

DR. BARBARA C. CAVANAUGH M.D.

Radiology (Diagnostic Radiology)

333 COTTMAN AVE
PHILADELPHIA, PA 19111

Philadelphia County (215) 728-3883

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 Thurmond's NPI number?

The NPI number for Mallory Thurmond is 1366391179. It was assigned to this individual provider in the NPPES registry on January 26, 2026.

Where is Mallory Thurmond located?

Mallory Thurmond practices at 333 Cottman Ave, Philadelphia, PA 19111. The listed phone number is (215) 728-2570.

What is Mallory Thurmond's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Mallory Thurmond enrolled in Medicare?

Yes. Mallory Thurmond 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.

When was this NPI record last updated?

The NPPES record for Mallory Thurmond was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.