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

Mallory K Bellissimo, PA-C

Individual provider Physician Assistant · NPI 1255640074

Mallory K Bellissimo, PA-C is a Physician Assistant in Atlanta, Georgia. Licensed in Georgia and Washington. Registered with an NPI since 2010.

Licensed in
GA, WA
In the registry since
2010
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3617 Roswell Rd NE
Atlanta, GA 30305-1111
Phone: (404) 996-0196
Fax: (404) 467-2489
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10513 (GA)
Physician Assistant Taxonomy 363A00000X · Licence PA60385985 (WA)

Record details

NPI number1255640074
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 28, 2010
Last updated in NPPESNovember 7, 2023
Certification dateNovember 7, 2023

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