Abigail Martha Harris Mallory, RD, MS is a medicare enrolled "Dietitian, Registered" provider in Hailey, Idaho. Her current practice location is
211 N 6th Ave, Hailey, Idaho. You can reach out to her office (for appointments etc.) via phone at
(802) 318-7232.
Abigail Martha Harris Mallory is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114519519.
Healthcare Provider's Profile
| Full Name | Abigail Martha Harris Mallory |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 211 N 6th Ave, Hailey, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1114519519
- Provider Enumeration Date: 02/07/2021
- Last Update Date: 02/07/2021
Medicare PECOS Information:
- PECOS PAC ID: 8729497839
- Enrollment ID: I20210430001732
Medical Identifiers
Medical identifiers for Abigail Martha Harris Mallory such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1114519519 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Abigail Martha Harris Mallory allows following entities to bill medicare on her behalf.
| Provider Name | St Lukes Clinic - Wood River Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1972891604
PECOS PAC ID: 3173783818
Enrollment ID: O20120404000474 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Abigail Martha Harris Mallory is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Abigail Martha Harris Mallory, RD, MS
Po Box 3413,
Ketchum, ID 83340-3369
Ph: (802) 318-7232 | Abigail Martha Harris Mallory, RD, MS
211 N 6th Ave,
Hailey, ID 83333-8867
Ph: (802) 318-7232 |
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