Individual provider Active NPI

Mandy Lynn Templet, NP-C

  • Family Nurse Practitioner
  • Gonzales, LA
National Provider Identifier
1407137128
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP06606 Issued in LA
Practice address
2647 S Saint Elizabeth Blvd Ste 311
Gonzales, LA 70737-5020
Phone
(225) 765-5500
Fax
(225) 743-2499
NPI assigned
Sep 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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 AP06606 LA Primary

Addresses

Primary practice location

2647 S Saint Elizabeth Blvd Ste 311
Gonzales, LA 70737-5020

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5727

Other names 1

  • Mandy Lynn Chaisson Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address mtemplet14454@direct.casso.us.com Direct

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
I20111221000664 LA Practitioner - Nurse Practitioner 6002082013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

2647 S Saint Elizabeth Blvd
Suite 311
Gonzales, LA 70737-5020
Phone (225) 743-2833

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06606LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner CurrentSince Mar 1, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Mar 1, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Past Accepting new patients

Locations

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

2647 S Saint Elizabeth Blvd
Ste 100
Gonzales, LA 70737
Phone (225) 743-2707

2647 S Saint Elizabeth Blvd
Ste 125
Gonzales, LA 70737
Phone (225) 647-9675

1023 W Highway 30
Gonzales, LA 70737
Phone (225) 743-2366

2647 S Saint Elizabeth Blvd
Ste 311
Gonzales, LA 70737
Phone (225) 743-2833

17609 Old Jefferson Hwy
Ste A
Prairieville, LA 70769

Interoperability endpoints

  • Direct secure messaging: mtemplet14454@direct.casso.us.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1407137128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 S SAINT ELIZABETH BLVD STE 311",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707375020",
            "telephone_number": "225-765-5500",
            "fax_number": "225-743-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLET",
        "first_name": "MANDY",
        "middle_name": "LYNN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP06606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/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": "2647 S Saint Elizabeth Blvd Ste 311",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtemplet14454@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mtemplet14454@direct.casso.us.com",
            "address_1": "2647 S Saint Elizabeth Blvd Ste 311",
            "city": "Gonzales",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707375020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MANDY",
            "last_name": "CHAISSON",
            "middle_name": "LYNN",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.