Mallory Quinn Johnson, RN
NPI 1972110815ActiveIndividual· Nurse Anesthetist, Certified Registered· Corbin, KY
Nurse Anesthetist, Certified Registered (RN) in Corbin, Kentucky, trained at Lincoln Memorial University Medical Department (class of 2020). Medicare paid $17,819 for services to 111 patients in 2024. Phathom Pharmaceuticals, Inc. reported $16.88 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1972110815 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RN |
| Sole proprietor | Yes |
| NPI issued | Sep 24, 2020 |
| Last updated in NPPES | Jan 15, 2021 |
| Certified by provider | Jan 15, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 3015641 | KY |
| Registered Nurse | 163W00000X | 1129317 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (KY) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 111 |
|---|---|
| Services billed | 143 across 46 procedure codes |
| Paid by Medicare | $17,819 |
Education and affiliations
| Medical school | Lincoln Memorial University Medical Department |
|---|---|
| Graduation year | 2020 |
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Commonwealth Anesthesia, PSCPaducah, KY · 178 clinicians
Hospital affiliation
- Saint Joseph LondonLondon, KY
Industry payments (Open Payments)
- 2024$16.88 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Phathom Pharmaceuticals, Inc. | $16.88 | 1 |
What the 2024 payments were for
- Food and Beverage$16.88 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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