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MALLORY CALLAWAY RD
NPI 1477207611
Dietitian, Registered in San Diego, CA

Active since February 07, 2022
4303 LA JOLLA VILLAGE DR STE 2110, SAN DIEGO, CA 92122(858) 657-8857 Get Directions Write a Review

NPPES record last updated: February 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mallory Callaway Rd NPPES

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

MALLORY CALLAWAY RD (NPI 1477207611) is an individual dietitian, registered in San Diego, California, licensed in California (86005489) and active in the NPI registry since February 2022. She maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1477207611
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameMALLORY CALLAWAYCredential: RD
Location Address4303 LA JOLLA VILLAGE DR STE 2110San Diego, CA 92122-1396
Mailing AddressPo Box 232410San Diego, CA 92193-2410
Phone(858) 657-8857
Sole ProprietorYes
Enumeration DateFebruary 7, 2022
Last NPPES UpdateFebruary 8, 2022
NPPES CertifiedFebruary 8, 2022
✔ NPI 1477207611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in CA · 86005489
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
4303 LA JOLLA VILLAGE DR STE 2110, San Diego, CA 92122
Open in Google Maps ↗

Secondary Practice Location 1

Location 1200 W Arbor DrSan Diego, CA 92103-9000 · Phone (800) 926-8273

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Callaway Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Mallory Callaway reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regents Of The University Of California
8.3 mi
Allergy & Immunology
200 W ARBOR DR
San Diego, CA 92103
  • Reassigned Medicare billing, California enrollment
  • Also billed through NPI 1740382993 (California)
  • 1,051 clinicians in this Medicare group
NPI 1487772380 (800) 926-8273

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 6

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

REBECA VANESSA DOMINGUEZ PROFETA MD
Surgery
4303 LA JOLLA VILLAGE DR STE 2110
SAN DIEGO, CA 92122
San Diego County (800) 926-8273
JAMES JEFFERY REEVES MD
Surgery
4303 LA JOLLA VILLAGE DR STE 2110
SAN DIEGO, CA 92122
San Diego County (800) 926-8273
JASON COREY XIA MD
Surgery
4303 LA JOLLA VILLAGE DR STE 2110
SAN DIEGO, CA 92122
San Diego County (800) 926-8273
ANA TERESA GARCIA CABRERA
Surgery
4303 LA JOLLA VILLAGE DR STE 2110
SAN DIEGO, CA 92122
San Diego County (800) 926-8273
DR. ERIKA NICOLE BAIRD MD
Surgery
4303 LA JOLLA VILLAGE DR STE 2110
SAN DIEGO, CA 92122
San Diego County (800) 926-8273
ANDREW BRYAN BARNES MD
Surgery
4303 LA JOLLA VILLAGE DR STE 2110
SAN DIEGO, CA 92122
San Diego County (800) 926-8273

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 Callaway's NPI number?

The NPI number for Mallory Callaway is 1477207611. It was assigned to this individual provider in the NPPES registry on February 7, 2022.

Where is Mallory Callaway located?

Mallory Callaway practices at 4303 La Jolla Village Dr Ste 2110, San Diego, CA 92122. The listed phone number is (858) 657-8857.

What is Mallory Callaway's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Mallory Callaway enrolled in Medicare?

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

Which organization bills Medicare for Mallory Callaway's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mallory Callaway reassigns Medicare benefits to Regents Of The University Of California (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mallory Callaway's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mallory Callaway was last updated on February 8, 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.