Vincent D. Mallory MD., LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VINCENT D. MALLORY MD., LLC

Practice address

3311 Prescott Rd
Suite 316
Alexandria, LA 71301-3900

Phone

(318) 487-1717

Fax

(318) 487-1170

NPI assigned

Mar 8, 2012

Organization subpart

No

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

Authorized official

Name

Constance Fisher Mallory

Title

Office Manger

Phone

(318) 487-1717

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8733/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joan Walker, MD

  • Family Medicine Physician
  • Natchitoches, LA
  • NPI 1861484933
  NPD (past)

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1215201215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD",
            "address_2": "SUITE 316",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013900",
            "telephone_number": "318-487-1717",
            "fax_number": "318-487-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD",
            "address_2": "SUITE 316",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013900",
            "telephone_number": "318-487-1717",
            "fax_number": "318-487-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT D. MALLORY MD., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "MALLORY",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "FISHER",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "318-487-1717"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1574520",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-INDIVIDUAL",
            "identifier": "1215918503",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Lynn Vidrine
• Jill Vidrine, NP
• Jordan Emile Vidrine, SRNA
• Shelby Helmer Vidrine, APRN-CNP
• Edward Ray Villemez II, M.D.
• Beckie Leigh Vincent
• Delandria Vincent
• La'Vannah Sha'Nyce Vinson, RN
• Vision Perspective Counseling
• Vision Source Alexandria LLC

• Primary Care Clinic/Center in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.