Doctor profile · Federal record
Dr. Mallory Park, MSN, CRNP, FNP-C
General Practice Physician (CMS: Nurse Practitioner) · Family Medicine Physician · Ridgway, PA
- NPI 1114755345
- Accepts Medicare
- 3 yrs in practice
- Female
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
250 W Main St
Ridgway, PA 158531611
(814) 772-8122 - Mailing address
-
101 Jenks St
Brookville, PA 158252303
Credentials & registration
- NPI registered
- July 2024 — 2 yrs on file
- Year of graduation
- 2023 — 3 yrs since
- Specialty taxonomy
- 208D00000X — NUCC code
- State license (1)
- Pennsylvania #SP030067
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1114755345. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$33
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Lilly USA, LLC | 1 | $17.38 | |
| AstraZeneca Pharmaceuticals Lp | 1 | $15.50 |
By nature of payment
Frequently asked questions
What is Dr. Mallory Park's medical specialty?
Dr. Mallory Park practices General Practice Physician in Ridgway, PA.
Where does Dr. Mallory Park practice?
Dr. Mallory Park practices at 250 W Main St, Ridgway, PA 158531611. Office phone: 8147728122.
What is Dr. Mallory Park's NPI?
Dr. Mallory Park's National Provider Identifier (NPI) is 1114755345, issued by NPPES.
Does Dr. Mallory Park accept Medicare assignment?
Yes. Dr. Mallory Park accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.