Mallory Leeann Broadaway, APRN-CNP in Trumann, AR

Mallory Leeann Broadaway, APRN-CNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Trumann, Arkansas. Her current practice location is 1704 Highway 69 West, Trumann, Arkansas. You can reach out to her office (for appointments etc.) via phone at (870) 483-4003.

Mallory Leeann Broadaway is licensed to practice in Arkansas (license number A003980) 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 1881023828.

Contact Information

	Mallory Leeann Broadaway, APRN-CNP
	1704 Highway 69 West, Trumann, AR 72472-2029
	(870) 483-4003
	(870) 483-4009

Map and Direction

Provider's Profile

Full Name	Mallory Leeann Broadaway
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1704 Highway 69 West, Trumann, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1881023828
Provider Enumeration Date: 11/08/2013
Last Update Date: 05/03/2021

Medicare PECOS Information:

PECOS PAC ID: 1557591237
Enrollment ID: I20140225000420

Medical Identifiers

Medical identifiers for Mallory Leeann Broadaway such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1881023828	NPI	-	NPPES
201676758	Medicaid	AR
5PA17	Other	AR	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	A003980 (Arkansas)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	A003980 (Arkansas)	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. Mallory Leeann Broadaway allows following entities to bill medicare on her behalf.

Entity Name	Families, Inc Of Arkansas
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770535569 PECOS PAC ID: 9335133669 Enrollment ID: O20040412000211

Entity Name	St Bernards Hospital Inc.
Entity Type	Part B Supplier - Hospital Department(s)
Entity Identifiers	NPI Number: 1518327287 PECOS PAC ID: 0941105480 Enrollment ID: O20070718000531

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. Mallory Leeann Broadaway 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
Mallory Leeann Broadaway, APRN-CNP 1815 Pleasant Grove Road, Jonesboro, AR 72401-7870 Ph: (870) 933-6886	Mallory Leeann Broadaway, APRN-CNP 1704 Highway 69 West, Trumann, AR 72472-2029 Ph: (870) 483-4003

Reviews and Comments

Nurse Practitioner Nurses in Trumann, AR

Mashae D. Rolland, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 808 Highway 463 N, Trumann, AR 72472 Phone: 870-483-7631 Fax: 870-483-7659
Mrs. Hollie Kay Mclaughlin, MSN, APN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 417 W Main St, Trumann, AR 72472 Phone: 870-483-7039 Fax: 870-483-0590
Jennifer L Crisp, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 516 Industrial Park Dr, Trumann, AR 72472 Phone: 870-936-8000 Fax: 870-934-3666
Jordan Brooke Fletcher, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 516 Industrial Park Dr, Trumann, AR 72472 Phone: 870-936-8000 Fax: 870-934-3666
Diana Michelle Montgomery, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 305 W. Main Street, Nea Baptist Clinic, Trumann, AR 72472 Phone: 870-483-6131 Fax: 870-483-2573
Madison G Chavers, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 516 Industrial Park Dr, Trumann, AR 72472 Phone: 870-936-8000 Fax: 870-934-3666

Mallory Leeann Broadaway, APRN-CNP - Medicare Nurse Practitioner in Trumann, AR