Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mallory Irene Chiang

Individual provider Physician Assistant · NPI 1174387773

Mallory Irene Chiang is a Physician Assistant in Pooler, Georgia. Qualified in 2024, 2 years ago. Practices with Consultants in Pain Medicine LLC, a 16-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
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Practice location Address checks out

200 Blue Moon Xing Ste 203
Pooler, GA 31322-9698
Phone: (912) 590-0973
Fax: (912) 590-0180
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1601 Fair Rd Ste 800, Statesboro, GA 30458-0800 — (912) 590-0973

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1174387773
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 13, 2024
Last updated in NPPESMay 21, 2024
Certification dateMay 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Consultants In Pain Medicine Llc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Pooler