Individual provider Active NPI

Mary Dahlen, APRN

  • Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1235358003
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
081161 Issued in LA
Practice address
1000 Walters St
Lake Charles, LA 70607-4647
Phone
(337) 475-8100
NPI assigned
Apr 24, 2007
Last updated
Dec 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 081161 LA Primary

Addresses

Primary practice location

1000 Walters St
Lake Charles, LA 70607-4647

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 475-8100

Other identifiers 1

IdentifierTypeStateIssuer
1022799MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070731000377 LA Practitioner - Nurse Practitioner 7517068893 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calcasieu Urgent Care LLCGroup PAC ID 5496908071, 132 clinicians

Practice addresses (Care Compare)

1017 N Pine St
Deridder Urgent Care
Deridder, LA 70634-2817
Phone (337) 202-4101

Merit-based Incentive Payment System (MIPS)

Final score
83.62 of 100Reported as group
Quality
70.88
Improvement activities
40
Cost
75.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
081161LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Medicine Management -- Lake Charles LLC CurrentSince Feb 15, 2024 Accepting new patients
Jefferson Davis Emergency Group LLC Nurse Practitioner CurrentSince Jan 15, 2014 Accepting new patients
Concord Medical Group PLLC CurrentSince Mar 1, 2023 Accepting new patients
Check Point Primary Care LLC CurrentSince Aug 5, 2025 Accepting new patients
Kisatchie Emergency Group, LLC Nurse Practitioner CurrentSince Jun 26, 2024 Accepting new patients
Sound Physicians Emergency Medicine of Louisiana Inc CurrentSince Sep 1, 2019 Accepting new patients
South Central Physicians PLLC CurrentSince Mar 1, 2023 Accepting new patients
Calcasieu Cameron Emergency Physician Group LLC CurrentSince Apr 1, 2015 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Mar 1, 2023 Accepting new patients
Abbeville Emergency Group LLC Nurse Practitioner CurrentSince Mar 10, 2020 Accepting new patients
University of Utah Emergency Physicians Past Accepting new patients

Locations

118 N Hospital Dr
Abbeville, LA 70510
Phone (337) 893-5466

104 Albertson Pkwy
Ste 6
Broussard, LA 70518

753 Odd Fellows Rd
Ste F
Crowley, LA 70526
Phone (337) 514-5233

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

1634 Elton Rd
Jennings, LA 70546
Phone (337) 616-7000

165 Beech Springs Rd
Jonesboro, LA 71251
Phone (318) 259-4435

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

1108 Parkview Dr
#A
New Iberia, LA 70563
Phone (337) 514-5234

2331 S Union St
Opelousas, LA 70570
Phone (337) 330-2339

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

Organizations & group practices 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1235358003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-475-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALTERS ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074647",
            "telephone_number": "337-475-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLEN",
        "first_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "081161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022799",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.