Mallory Lassalle, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

221800 Issued in LA

Practice address

200 Henry Clay Ave
New Orleans, LA 70118-5798

Phone

(504) 896-9418

NPI assigned

Aug 24, 2021

Last updated

Dec 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mallory Leblanc Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Children's Hospital

  dba Manning Family Children's - Physician Billing

  • Specialist
  • New Orleans, LA
  • NPI 1306156138
  Medicare reassignment NPD
• Thibodaux Regional Network Development Corporation

  dba Thibodaux Regional Radiology

  • Diagnostic Radiology Physician
  • Thibodaux, LA
  • NPI 1467427336
  NPD (past)

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1730856204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 ROSA AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700052127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185798",
            "telephone_number": "504-896-9418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSALLE",
        "first_name": "MALLORY",
        "name_prefix": "Mrs.",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "LA",
            "license": "221800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "LEBLANC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haivyn Lasalle
• Ghazal Lashgari, M.D.
• Joseph Lasky, MD
• Catherine Lasperches, MSN
• Emma Lassalle, PA-C
• Megan Nicole Lassard, AUD
• Mary Lasseigne, LCSW-BACS
• Nicole Trosclair Lasserre, PHD, BCBA-D, LBA
• Jacquelyn Higgins Laster
• Ashton Joseph Lastrapes, MSN NP

• Neonatal Nurse Practitioner in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Neonatal Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.