Carl G Mallett, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

03828 Issued in LA

Practice address

1128 Hidden Oak LN
Lake Charles, LA 70605-7123

Phone

(337) 478-1085

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Glen D. Hurlston, M.D., Apmc 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Byrd Regional Hospital Hospital, Leesville, LA, CCN 190164

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glen D. Hurlston, M.D., Apmc

  • Anesthesiology Physician
  • Leesville, LA
  • NPI 1306913488

  LA

  Medicare reassignment Care Compare group NPD
• DRS Burleigh, Dupleix and Rees

  • Anesthesiology Physician
  • Lafayette, LA
  • NPI 1659368694
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CLHG-Leesville

  • General Acute Care Hospital
  • Leesville, LA
  • NPI 1881665164

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1104806124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 HIDDEN OAK LN",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706057123",
            "telephone_number": "337-478-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 HIDDEN OAK LN",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706057123",
            "telephone_number": "337-478-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETT",
        "first_name": "CARL",
        "middle_name": "G",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "03828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00140225",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1115096",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tashfeen Mahmood, M.D.
• Brandi A Malbrew, COTA
• Joycelynn Malbrough
• Katherine Mallet, MSN, FNP-C
• Alicia Fonda Mallett
• Debra Tower Mallett, CRNA
• Ericka Arlene Mallett, FNP
• John Shane Mallett, CRNA
• Malve Management Solutions LLC
• Danella Malveaux, NP

• All providers in Lake Charles, LA
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.