MICHELLE MALLORY (RD) – Registered Dietitian, NPI 1477963650

MICHELLE MALLORY (RD) is a healthcare provider. based in Sparks, Nevada. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD. They hold a License No. 86028933 (NV). The NPI Number for MICHELLE MALLORY (RD) is 1477963650

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MICHELLE MALLORY (RD)
NPI
1477963650
Phone
(775) 356-9393
Address
2345 E. PRATER WAY, SUITE 207
Enumeration Date
28 April 2014
Last Update Date
28 September 2017

Doctor Profile

Medical School Name
UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Secondary Phone
7023138446
Graduation Year
2012 (14 years ago)
PAC ID
2466671375
Group Practice PAC ID
5193988863
Professional Enrollment ID
I20140908001732
Address ID
NV891073112LA3802XLNXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

65 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in NV

Provider Addresses for MICHELLE MALLORY (RD)

  • 2345 E. PRATER WAY, SUITE 207

    SPARKS, NV 89434

    Phone: (775) 356-9393

    Fax: (775) 356-5590

    Type: Mailing

  • 3802 MEADOWS LN

    LAS VEGAS, NV 891073112

    Phone: (702) 313-8446

    Fax: (702) 221-8446

    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: 2014-09-08

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
I20140908001732IRegistered Dietitian Or Nutrition ProfessionalNVTBD

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 89434)

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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: 5193988863View full group profile
NameSpecialtyState
Registered Dietitian Or Nutrition ProfessionalNV
General SurgeryNV
General SurgeryNV
Physician AssistantNV
General SurgeryNV

Reviews

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Frequently asked questions

Where can patients find MICHELLE MALLORY (RD)'s NPI?
You can confirm MICHELLE MALLORY (RD) with NPI 1477963650; it appears in the national provider directory.
Is MICHELLE MALLORY (RD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MICHELLE MALLORY (RD) treat or focus on?
Patients typically see MICHELLE MALLORY (RD) under the specialty Registered Dietitian. Clinical services aligned with this taxonomy classification.
What location metadata exists for MICHELLE MALLORY (RD)?
The page summarizes Sparks, Nevada for MICHELLE MALLORY (RD); expand the address list for detail.
What if Sparks, Nevada seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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