Individual Healthcare Provider
Mallori Wisuri Hathaway, PA-C
Provider's NPPES record last updated: November 12, 2025
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1861019689
- Primary Specialty
- Physician Assistant
- Practice Location
- Scottsburg, Indiana
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 19, 2026, 12:39 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Taxonomy code 363A00000X
Provider-Reported License Information
- Physician Assistant (Indiana)
- 10003222A
Practice Locations
Practice Location
1428 N Gardner St
Scottsburg, Indiana 47170-8720
Phone: (812) 752-3512
Additional Practice Location
244 Westwood Blvd
Columbus, Indiana 47201-5687
Phone: (812) 669-0141
Fax: (888) 358-7705
Additional Practice Location
415 S Landmark Ave
Bloomington, Indiana 47403-5003
Phone: (812) 333-7433
Fax: (812) 733-7435
Additional Practice Location
505 W Homer St Ste 201
Salem, Indiana 47167-1698
Phone: (812) 883-0024
Fax: (812) 883-8574
Additional Practice Location
911 N Shelby St
Salem, Indiana 47167-2304
Phone: (812) 883-8527
Fax: (812) 883-8574
Additional Practice Location
2130 W Sycamore St Ste 200
Kokomo, Indiana 46901-6461
Phone: (765) 457-4455
Fax: (765) 457-0056
Additional Practice Location
1263 Hospital Dr Nw Ste 100
Corydon, Indiana 47112-2173
Phone: (812) 783-2054
Fax: (812) 733-7838
Additional Practice Location
303 S Walnut St
Seymour, Indiana 47274-2368
Phone: (812) 358-7705
Fax: (888) 254-0293
Record Information
- Enumeration Date
- June 27, 2020
- Provider's NPPES Record Last Updated
- November 12, 2025
- Certification Date
- November 12, 2025
- NPISignal NPPES Dataset
- August 2026
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