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Active NPI 1114755345 Individual Practitioner Female Practitioner

Mallory Lynn Park , MSN, CRNP, FNP-C

General Practice • Ridgway, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Mallory Park, MSN, CRNP, FNP-C is a certified General Practice practicing in Ridgway, PA. With approximately 3 years of clinical experience since completing medical education in 2023, Mallory Park delivers high-quality medical care to the local community at 250 W MAIN ST.

Mallory Park maintains professional affiliations with Wellnow Urgent Care, P.C., Dubois Regional Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

250 W Main St

Ridgway, PA 158531611

Telephone 8147728122
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2023

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Ridgway, PA

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
3 Yrs Matches City Avg
City Avg: 3.0 Yrs
State Avg: 29.8 Yrs
Regional Practice Density
1 Specialists

Practicing in Ridgway, PA (434 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
20.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Park (3 Years) 3 Yrs
Ridgway Specialty Average (3.0 Years) 3.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
13 12 $68.00 $54.27

Medical Specialties & State Licenses

CMS Verified: 2024-07-08
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License PA SP030067

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Family Medicine

NUCC Taxonomy Code: 207Q00000X

State License PA SP030067

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Hospital & Practice Group Affiliations

Dubois Regional Medical Center

250 W Main St, Ridgway, PA 158531611

Phone: 8147728122

Wellnow Urgent Care, P.c.

917 S Saint Marys St, Saint Marys, PA 158572828

Phone: 8143891026

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Katie Kerr

Nurse Practitioner - Family

NPI 1235704701
Jacki Depanfilis , PA-C

Physician Assistant - Medical

NPI 1245583665

Physician Assistant (Certified)

Troy Templeton , PA

Physician Assistant

NPI 1316477656

Physician Assistant

NPI 1801207576

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 22, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location July 22, 2024

Registered at 250 W MAIN ST, RIDGWAY, PA 158531611 (Tel: 8147728122)

📍
Updated Business Mailing Address July 22, 2024

Registered at 101 JENKS ST, BROOKVILLE, PA 158252303

👤
Provider Name / Credentials Updated July 22, 2024

Recorded as MALLORY PARK, MSN, CRNP, FNP-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2024

Family Medicine (License #SP030067 in PA)

🟢
Initial NPI Registration & Enumeration July 22, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114755345
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 22, 2024
Last Update: July 22, 2024
Sole Proprietor: No

Mailing Address

101 Jenks St

Brookville, PA 158252303

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.