Individual provider Active NPI

Mallory Knight Varnado, MD

  • Family Medicine Physician
  • Bogalusa, LA
National Provider Identifier
1538919428
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
349807 Issued in LA
Practice address
420 Avenue F
Bogalusa, LA 70427-3634
Phone
(985) 730-6970
NPI assigned
Mar 25, 2024
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 349807 LA Primary

Addresses

Primary practice location

420 Avenue F
Bogalusa, LA 70427-3634

Mailing address

420 Avenue F
Bogalusa, LA 70427-3634
Phone (985) 730-6970

Other names 1

  • Mallory Danielle Knight Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628002575 LA Order and Referring Only - Family PracticePractitioner - Family Practice 9638613862

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

301 Walnut St
Amite, LA 70422-2025

4100 International PLZ
Fort Worth, TX 76109-4800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Hospital & facility affiliations 7

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1538919428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 AVENUE F",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273634",
            "telephone_number": "985-730-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 AVENUE F",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273634",
            "telephone_number": "985-730-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNADO",
        "first_name": "MALLORY",
        "middle_name": "KNIGHT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "349807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "KNIGHT",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.