MALLORY BROOKE JOHNSON NP
NPI 1518520238
Nurse Practitioner in Charlotte, NC

Q: What is Mallory Johnson's NPI number?

The NPI number for Mallory Johnson is 1518520238. It was assigned to this individual provider in the NPPES registry on April 18, 2019. The provider is also known as Mallory Brooke Dotson Np.

Q: What is Mallory Johnson'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 Johnson was last updated on June 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since April 18, 2019PECOS EnrolledAccepts Medicare Assignment

125 QUEENS RD STE 610, CHARLOTTE, NC 28204(980) 302-6600(980) 302-6605 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 25, 2024, Aug 18, 2021, Jun 15, 2021 and 4 more (7 updates tracked since 2019).

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About Mallory Brooke Johnson Np NPPES

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

MALLORY BROOKE JOHNSON NP (NPI 1518520238) is an individual nurse practitioner in Charlotte, North Carolina, licensed in North Carolina (5011691) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Novant Health New Hanover Regional Medical Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1518520238

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMALLORY BROOKE JOHNSONCredential: NP

Location Address125 QUEENS RD STE 610Charlotte, NC 28204-3580

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (980) 302-6600 · Fax (980) 302-6605

Phone(980) 302-6600

Fax(980) 302-6605

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 18, 2019

Last NPPES UpdateJune 25, 20247 updates tracked since enumeration

NPPES CertifiedJune 25, 2024

✔ NPI 1518520238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NC · 5011691

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.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 5011691 (NC)

125 QUEENS RD STE 610, Charlotte, NC 28204

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Other Names 1

Former Name (1)Mallory Brooke Dotson Np

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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 Brooke Johnson Np 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 ID8426382391

PECOS Enrollment IDI20190626002190

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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Novant Health New Hanover Regional Medical Center

Acute Care Hospitals · Wilmington, NC

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number340141

Location2131 S 17th St Box 9000Wilmington, NC 28402 · New Hanover County

Emergency services Birthing friendly

Novant Health Brunswick Medical Center

Acute Care Hospitals · Supply, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number340158

Location1 Medical Center Dr PO Box 139Supply, NC 28462 · Brunswick County

Emergency services Birthing friendly

Pender Memorial Hospital

Critical Access Hospitals · Burgaw, NC

OwnershipGovernment - Local

CMS Certification Number341307

Location507 E Fremont StBurgaw, NC 28425 · Pender County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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 12

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

DR. DAVID ALAN RIZZIERI M.D.

Internal Medicine (Medical Oncology)