Mrs Mallory Smith, NP in Shaw Afb, SC - Medicare Nurse Practitioner

Mrs Mallory Smith, NP is a medicare enrolled "Nurse Practitioner - Primary Care" in Shaw Afb, South Carolina. Her current practice location is 420 Polifka Dr, Shaw Afb, South Carolina. You can reach out to her office (for appointments etc.) via phone at (803) 895-2273.

Mrs Mallory Smith is licensed to practice in South Carolina (license number 26148) 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 1003533357.

Contact Information

	Mrs Mallory Smith, NP
	420 Polifka Dr, Shaw Afb, SC 29152-5100
	(803) 895-2273
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Mallory Smith
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	420 Polifka Dr, Shaw Afb, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003533357
Provider Enumeration Date: 10/26/2022
Last Update Date: 09/19/2025

Medicare PECOS Information:

PECOS PAC ID: 9436521390
Enrollment ID: I20230202002696

Medical Identifiers

Medical identifiers for Mrs Mallory Smith such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003533357	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	26148 (South Carolina)	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. Mrs Mallory Smith allows following entities to bill medicare on her behalf.

Entity Name	Tandem Health Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386630192 PECOS PAC ID: 3870575855 Enrollment ID: O20040603000514

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. Mrs Mallory Smith 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
Mrs Mallory Smith, NP 420 Polifka Dr, Shaw Afb, SC 29152-5100 Ph: (803) 895-2273	Mrs Mallory Smith, NP 420 Polifka Dr, Shaw Afb, SC 29152-5100 Ph: (803) 895-2273

Reviews and Comments

Nurse Practitioner Nurses in Shaw Afb, SC

Ms. Lauren Carol Allain, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 431 Meadowlark St., 20th Mdg/sghc, Shaw Afb, SC 29152 Phone: 803-895-6356 Fax: 803-895-6456
Jacqueline Mintz, ARNP-FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 524 Nelson Ave, Shaw Afb, SC 29152 Phone: 706-495-6612
Lorraine Rivero, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152 Phone: 843-895-6449
Dr. Leslie Marie Filler, DNP, APRN, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152 Phone: 803-895-6425
Diane Susan White, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 420 Polifka Dr Bldg 1042, Shaw Afb, SC 29152 Phone: 803-895-6356
Kimberly Marie Shanks, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 431 Meadowlark Rd, Shaw Afb, SC 29152 Phone: 803-895-6592

Mrs Mallory Smith, NP - Medicare Nurse Practitioner in Shaw Afb, SC