Individual provider Active NPI

Mary Lyn Dore, APRN

  • Family Nurse Practitioner
  • Sulphur, LA
National Provider Identifier
1689438764
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
234472 Issued in LA
Practice address
600 Cypress St
Sulphur, LA 70663-5052
Phone
(337) 527-6371
NPI assigned
Feb 9, 2024
Last updated
Mar 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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 234472 LA Primary

Addresses

Primary practice location

600 Cypress St
Sulphur, LA 70663-5052

Mailing address

2853 Christy Dr
Lake Charles, LA 70611-3658
Phone (337) 540-4963

Other practice location 1

108 6th Ave Bldg B
Kinder, LA 70648-3187
Phone (337) 738-9494

Other identifiers 1

IdentifierTypeStateIssuer
2653091MedicaidLA

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
I20240417001533 LA Practitioner - Nurse Practitioner 6901245422 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group PLLCGroup PAC ID 0446296818, 189 clinicians

Practice addresses (Care Compare)

108 6TH Ave
Kinder, LA 70648-3187
Phone (337) 738-2527

600 S Pine St
Deridder, LA 70634-4942
Phone (337) 462-7100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234472LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Medical Group PLLC CurrentSince Jan 7, 2025 Accepting new patients
Allen Parish Hospital District No 3 CurrentSince Feb 1, 2025 Accepting new patients
Calcasieu Cameron Emergency Physician Group LLC CurrentSince Mar 1, 2024 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jan 7, 2025 Accepting new patients
Allen Parish Hospital District No 3 CurrentSince Feb 1, 2025 Accepting new patients
Allen Parish Hospital District No 3 Past Accepting new patients
Sulphur Pediatric Clinic Medical Corporation Past Accepting new patients

Locations

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

108 6th Ave
Kinder, LA 70648
Phone (337) 738-2527

108 6th Ave
Bldg B
Kinder, LA 70648
Phone (337) 738-4670

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

Organizations & group practices 7

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.

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1689438764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 CHRISTY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706113658",
            "telephone_number": "337-540-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CYPRESS ST",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706635052",
            "telephone_number": "337-527-6371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 6th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Kinder",
            "state": "LA",
            "postal_code": "706483187",
            "country_code": "US",
            "telephone_number": "337-738-9494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORE",
        "first_name": "MARY",
        "middle_name": "LYN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "234472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2653091",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

Verify at the official NPI Registry.