MALLORY N BLASSINGHAM (DPT) – Physical Therapist, NPI 1073373411

MALLORY N BLASSINGHAM (DPT) is a healthcare provider. based in Rockford, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 070.028112 (IL). The NPI Number for MALLORY N BLASSINGHAM (DPT) is 1073373411

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MALLORY N BLASSINGHAM (DPT)
NPI
1073373411
Phone
(815) 227-1700
Address
2662 MCFARLAND RD
Enumeration Date
21 March 2024
Last Update Date
21 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8152345553
Graduation Year
2023 (3 years ago)
PAC ID
0244671550
Group Practice PAC ID
8527492354
Professional Enrollment ID
I20240516002491
Address ID
IL610108626BY209XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

5,028 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

Provider Addresses for MALLORY N BLASSINGHAM (DPT)

  • 2662 MCFARLAND RD

    ROCKFORD, IL 611076806

    Phone: (815) 227-1700

    Fax: (815) 227-1744

    Type: Mailing

  • 209 N UNION ST

    BYRON, IL 610108626

    Phone: (815) 234-5553

    Fax: (815) 234-5557

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-05-16

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
I20240516002491IPhysical Therapist In Private PracticeILTBD

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 61107)

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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: 8527492354View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Occupational Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

What number should I use to identify MALLORY N BLASSINGHAM (DPT) for billing?
Administrative and clinical systems typically use NPI 1073373411 for MALLORY N BLASSINGHAM (DPT).
Is MALLORY N BLASSINGHAM (DPT) currently accepting referrals based on NPI status?
Registry metadata lists MALLORY N BLASSINGHAM (DPT) as active.
What does the directory say MALLORY N BLASSINGHAM (DPT) does?
Insurance directories may phrase it differently, but here MALLORY N BLASSINGHAM (DPT) maps to Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to MALLORY N BLASSINGHAM (DPT)?
MALLORY N BLASSINGHAM (DPT) shows a connection to Rockford, Illinois in registry-derived data.
Can I export MALLORY N BLASSINGHAM (DPT)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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