Individual provider Active NPI

Mary Meadows Bennett, R.N., N.P.

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1356567135
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP05163 Issued in LA
Practice address
7777 Hennessy Blvd
Suite 1000
Baton Rouge, LA 70808-4300
Phone
(225) 767-3900
Fax
(225) 214-9109
NPI assigned
Apr 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP05163 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd
Suite 1000
Baton Rouge, LA 70808-4300

Mailing address

7777 Hennessy Blvd
Suite 1000
Baton Rouge, LA 70808-4300
Phone (225) 767-3900

Other practice location 1

433 Plaza St Ste 514
Bogalusa, LA 70427-3729
Phone (985) 730-7023

Other practice location 2

31985 Highway 16
Suite B
Denham Springs, LA 70726
Phone (225) 767-3900

Other identifiers 2

IdentifierTypeStateIssuer
NPOtherLAAP05163
RNOtherLARN036633

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mbennett15916@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/ Other

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
I20070711000300 LA Practitioner - Nurse Practitioner 6507966249 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP05163LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge General Physicians, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince May 31, 2018 Accepting new patients
Baton Rouge General Physicians, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner CurrentSince May 31, 2018 Accepting new patients
Baton Rouge General Physicians, Inc. Past Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Past Accepting new patients

Locations

6516 E Myrtle Ave
Baker, LA 70714
Phone (225) 774-7320

8595 Picardy Ave
Ste 202
Baton Rouge, LA 70809
Phone (225) 964-5514

7777 Hennessy Blvd
Ste 1000
Baton Rouge, LA 70808
Phone (225) 769-3900

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8595 Picardy Ave
Ste 320
Baton Rouge, LA 70809
Phone (225) 237-1880

402 N Vaughan Dr
Brusly, LA 70719
Phone (225) 749-2645

31985 LA Highway 16
Ste B
Denham Springs, LA 70726
Phone (225) 767-1390

2647 S Saint Elizabeth Blvd
Ste 300
Gonzales, LA 70737
Phone (225) 647-0347

2647 S Saint Elizabeth Blvd
Ste 215
Gonzales, LA 70737
Phone (225) 765-5864

59315 River West Dr
#C
Plaquemine, LA 70764
Phone (225) 687-6629

610 N Jefferson Ave
Port Allen, LA 70767
Phone (225) 267-6626

5000 Odonavan Blvd
Ste 307
Walker, LA 70785
Phone (225) 791-3117

Interoperability endpoints

  • Direct secure messaging: mbennett15916@direct.casso.us.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1356567135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-767-3900",
            "fax_number": "225-214-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-767-3900",
            "fax_number": "225-214-9109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 Plaza St Ste 514",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273729",
            "country_code": "US",
            "telephone_number": "985-730-7023",
            "fax_number": "985-730-7024",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31985 Highway 16",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Denham Springs",
            "state": "LA",
            "postal_code": "70726",
            "country_code": "US",
            "telephone_number": "225-767-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARY",
        "middle_name": "MEADOWS",
        "name_prefix": "Ms.",
        "credential": "R.N., N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AP05163",
            "identifier": "NP",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN036633",
            "identifier": "RN",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbennett15916@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mbennett15916@direct.casso.us.com",
            "address_1": "7777 Hennessy Blvd",
            "address_2": "Suite 1000",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7777 Hennessy Blvd",
            "address_2": "Suite 1000",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.