MALLORY RUTH WISDOM FNP-C
NPI 1396551412
Nurse Practitioner - Family in Rogers, AR
About Mallory Ruth Wisdom Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALLORY RUTH WISDOM FNP-C (NPI 1396551412) is an individual family provider in Rogers, Arkansas, licensed in Arkansas (216033) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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 Ruth Wisdom 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 72756 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROGERS, AR 72756
ROGERS, AR 72756
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 Wisdom's NPI number?
The NPI number for Mallory Wisdom is 1396551412. It was assigned to this individual provider in the NPPES registry on December 4, 2024.
Where is Mallory Wisdom located?
Mallory Wisdom practices at 1233 W Poplar St, Rogers, AR 72756. The listed phone number is (479) 636-9235.
What is Mallory Wisdom's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mallory Wisdom enrolled in Medicare?
Yes. Mallory Wisdom 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.
What insurance does Mallory Wisdom accept?
Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Mallory Wisdom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mallory Wisdom was last updated on July 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Mallory Ruth Wisdom, FNP-C · NPI 1396551412
Family physician in Rogers, Arkansas. Individual provider, active in the CMS NPPES registry since December 4, 2024.
## Identity
- **NPI:** 1396551412 (Entity type: Individual)
- **Enumerated:** December 4, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 216033 (Arkansas)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1233 W POPLAR ST, Rogers, AR 72756-4245
- **Phone:** (479) 636-9235 · **Fax:** (479) 751-2878
## 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 2021
## Record status
- **NPPES last updated:** July 30, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1396551412) · Data from the CMS NPPES public registry.