MALLORY BOYETTE – Family Nurse Practitioner, NPI 1013578640

MALLORY BOYETTE is a healthcare provider. based in Savannah, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN234868 (GA). The NPI Number for MALLORY BOYETTE is 1013578640

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
MALLORY BOYETTE
NPI
1013578640
Phone
(912) 667-0071
Address
100 OATLAND ISLAND RD
Enumeration Date
25 June 2019
Last Update Date
22 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9123548225
Graduation Year
2019 (7 years ago)
PAC ID
7911449004
Group Practice PAC ID
9830693993
Professional Enrollment ID
I20240604003066
Address ID
GA314063101SA6711XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MALLORY BOYETTE

  • 100 OATLAND ISLAND RD

    SAVANNAH, GA 314101157

    Phone: (912) 667-0071

    Type: Mailing

  • 5354 REYNOLDS STREET

    PROFESSIONAL BUILDING SUITE 318

    SAVANNAH, GA 31405

    Phone: (912) 819-4870

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $38.

Total Amount is formed as General ($38) + Research ($0) + Ownership ($0) = $38.

Last reported payment date: 2024-04-17 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($38).

Total Amount

$38

General + Research + Ownership

Payments

2

Total payment records

General Amount

$38

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240604003066INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31410)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830693993View full group profile
NameSpecialtyState
Nurse PractitionerGA
Nurse PractitionerFL
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerFL
Nurse PractitionerGA
Family PracticeFL
General SurgeryGA
Nurse PractitionerGA
Family PracticeVA

Reviews

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Frequently asked questions

Where can patients find MALLORY BOYETTE's NPI?
You can confirm MALLORY BOYETTE with NPI 1013578640; it appears in the national provider directory.
Does this profile mean MALLORY BOYETTE is currently active?
Yes — MALLORY BOYETTE appears active in the national provider directory.
Can you summarize MALLORY BOYETTE's specialty in plain language?
Clinically, the directory lists MALLORY BOYETTE with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is MALLORY BOYETTE's primary listing?
We display Savannah, Georgia because that is what the record indicates for MALLORY BOYETTE.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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