Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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Mallori Wisuri Hathaway, PA-C

Individual provider Physician Assistant · NPI 1861019689

Mallori Wisuri Hathaway, PA-C is a Physician Assistant in Scottsburg, Indiana. Qualified in 2021, 5 years ago. Practices with Forefront Dermatology SC, a 645-clinician group, works from 8 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
5
Licensed in
IN
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

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Practice location Address checks out

1428 N Gardner St
Scottsburg, IN 47170-8720
Phone: (812) 752-3512
Fax: (812) 752-8593
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (7)

  • 415 S Landmark Ave, Bloomington, IN 47403-5003 — (812) 333-7433
  • 244 Westwood Blvd, Columbus, IN 47201-5687 — (812) 669-0141
  • 1263 Hospital Dr Nw Ste 100, Corydon, IN 47112-2173 — (812) 783-2054
  • 2130 W Sycamore St Ste 200, Kokomo, IN 46901-6461 — (765) 457-4455
  • 505 W Homer St Ste 201, Salem, IN 47167-1698 — (812) 883-0024
  • 911 N Shelby St, Salem, IN 47167-2304 — (812) 883-8527
  • 303 S Walnut St, Seymour, IN 47274-2368 — (812) 358-7705

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10003222A (IN)

Record details

NPI number1861019689
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 27, 2020
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Forefront Dermatology Sc — 645 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients907
Services billed 10,132 a service is one billed item, such as a visit, a test or a procedure
Average patient age72

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $751 46 payments · a meal or drink at a meeting or visit, not a fee
Education $100 1 payment · educational material or training, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

  • Norton Scott Hospital Hospital · Scottsburg, IN · listed as Norton Scott Hospital, LLC
  • Ascension St Vincent Salem Hospital · Salem, IN

Colleagues at Forefront Dermatology SC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 645 clinicians in the practice; 12 are shown here.

Other providers in Scottsburg