MALLORY FERGUSON – Physical Therapist, NPI 1346724176

MALLORY FERGUSON is a healthcare provider. based in Mound city, Missouri. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PT60868468 (WA). The NPI Number for MALLORY FERGUSON is 1346724176

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MALLORY FERGUSON
NPI
1346724176
Phone
Not provided
Address
1401 SAVANNAH ST
Enumeration Date
18 September 2018
Last Update Date
8 November 2019

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8162339888
Graduation Year
2013 (13 years ago)
PAC ID
0941633358
Group Practice PAC ID
5294700449
Professional Enrollment ID
I20191125002276
Address ID
MO645063082SA3107XAVEX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:7State licenses:3Digital endpointsOther names

1,533 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MO

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Provider Addresses for MALLORY FERGUSON

  • 1401, Savannah Street, Mound City, Holt County, Missouri, 64470, United States

    MOUND CITY, MO 644701539

    Phone:

    Mailing address matches the actual address.

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: 2019-11-25

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
I20191125002276IPhysical Therapist In Private PracticeMOTBD

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 64470)

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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: 5294700449View full group profile
NameSpecialtyState
Physician AssistantMO
Orthopedic SurgeryVA
Physician AssistantMO
Orthopedic SurgeryMO
Physician AssistantGA
Orthopedic SurgeryMO
-MO
Nurse PractitionerMO
Orthopedic SurgeryMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

Can I use this page to confirm MALLORY FERGUSON's NPI?
Yes. MALLORY FERGUSON is listed with NPI 1346724176 in the public NPI dataset.
Does the file indicate MALLORY FERGUSON is practicing under active NPI?
Directory data currently reports MALLORY FERGUSON as active.
What healthcare role does MALLORY FERGUSON hold?
Scheduling teams often label MALLORY FERGUSON under Physical Therapist. Clinical services aligned with this taxonomy classification.
What address line appears for MALLORY FERGUSON?
MALLORY FERGUSON's geographic hint is Mound City, Missouri in our summary view.
Why does MALLORY FERGUSON have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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