ETHAN DAVIS MALLORY FNP-C
NPI 1922976422
Nurse Practitioner - Family in Joplin, MO

Q: What is Ethan Mallory's NPI number?

The NPI number for Ethan Mallory is 1922976422. It was assigned to this individual provider in the NPPES registry on October 27, 2025.

Q: What is Ethan Mallory's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Mallory was last updated on October 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 October 27, 2025

3201 MCCLELLAND BLVD, SUITE B, JOPLIN, MO 64804(417) 347-6625 Get Directions Write a Review

NPPES record last updated: October 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ethan Davis Mallory Fnp-c NPPES

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

ETHAN DAVIS MALLORY FNP-C (NPI 1922976422) is an individual family provider in Joplin, Missouri, licensed in Missouri (2025036708) and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1922976422

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameETHAN DAVIS MALLORYCredential: FNP-C

Location Address3201 MCCLELLAND BLVD, SUITE BJoplin, MO 64804

Mailing Address3708 ChelseaWebb City, MO 64870-9572 · (417) 483-2014

Phone(417) 347-6625

Sole ProprietorNo

Enumeration DateOctober 27, 2025

NPPES CertifiedOctober 8, 2025

✔ NPI 1922976422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MO · 2025036708

3201 MCCLELLAND BLVD, Joplin, MO 64804

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Other Providers at the Same Location NPPES 2

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

STONES CORNER PHARMACY, INC.

Pharmacy (Community/Retail Pharmacy)

3201 MCCLELLAND BLVD
JOPLIN, MO 64804

Newton County (417) 347-6337

DESIRAE CHRISTAN HICKMAN SWEET PHARMACIST (PHARMD)

Pharmacist

3201 MCCLELLAND BLVD
JOPLIN, MO 64804

Newton County (417) 347-6337

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 Ethan Mallory's NPI number?

The NPI number for Ethan Mallory is 1922976422. It was assigned to this individual provider in the NPPES registry on October 27, 2025.

Where is Ethan Mallory located?

Ethan Mallory practices at 3201 Mcclelland Blvd Suite B, Joplin, MO 64804. The listed phone number is (417) 347-6625.

What is Ethan Mallory's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Ethan Mallory was last updated on October 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.