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MALLORY FAITH REARDEN DO
NPI 1629727870
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since March 23, 2022PECOS Enrolled
1402 S GRAND BLVD # M260, SAINT LOUIS, MO 63104(618) 780-9106 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mallory Faith Rearden Do NPPES

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

MALLORY FAITH REARDEN DO (NPI 1629727870) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629727870
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMALLORY FAITH REARDENCredential: DO
Location Address1402 S GRAND BLVD # M260Saint Louis, MO 63104-1004
Mailing Address5200 Autumnwinds DrSaint Louis, MO 63129-2462
Phone(618) 780-9106
Sole ProprietorNo
Enumeration DateMarch 23, 2022
NPPES CertifiedMarch 23, 2022
✔ NPI 1629727870 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
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.
1402 S GRAND BLVD # M260, Saint Louis, MO 63104
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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 Faith Rearden Do 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.

ANDRE CAMILLE JOSEPH III MD
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (314) 257-8000
JONATHAN F BREWER MD
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2919
RAINA D PATEL DO
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2408
NICHOLAS AFSHARI
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (314) 977-9851
JOSEPH HOYLE
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2359
BLAKE ANDERSON DO
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (618) 210-5609
ALIZABETH WEBER MD
Otolaryngology
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (509) 844-6535
DR. MICHAEL LUGO MD
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
St. Louis City (714) 345-8727

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 Rearden's NPI number?

The NPI number for Mallory Rearden is 1629727870. It was assigned to this individual provider in the NPPES registry on March 23, 2022.

Where is Mallory Rearden located?

Mallory Rearden practices at 1402 S Grand Blvd # M260, Saint Louis, MO 63104. The listed phone number is (618) 780-9106.

What is Mallory Rearden'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 Rearden enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Mallory Rearden was last updated on March 23, 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.