Mark C Mouton MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD.201233 Issued in LA

Legal business name

MARK C MOUTON MD LLC

Practice address

12880 Plank Rd
Baker, LA 70714-4909

Phone

(225) 774-7111

Fax

(225) 774-7714

NPI assigned

Apr 29, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark Christian Mouton, MDNPI 1164613758

Title

Member

Phone

(504) 621-3298

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Christian Mouton, M.D.

  • Internal Medicine Physician
  • Baker, LA
  • NPI 1164613758
  Medicare reassignment Care Compare group Authorized official
• Lauri Garrett, NP-C

  • Family Nurse Practitioner
  • Slaughter, LA
  • NPI 1063082279
  Medicare reassignment Care Compare group NPD
• Elizabeth Ann Mouton, FNP

  • Family Nurse Practitioner
  • Baker, LA
  • NPI 1760905343
  Medicare reassignment Care Compare group
• Stephanie Linton Nolan, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Baker, LA
  • NPI 1912262429
  Medicare reassignment Care Compare group
• Dorothy A Ewen, NP-C

  • Family Nurse Practitioner
  • Baker, LA
  • NPI 1639562515
  Medicare reassignment
• Kimberly Groht Watson, FNP-BC

  • Family Nurse Practitioner
  • Zachary, LA
  • NPI 1992461461
  Medicare reassignment

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1760626170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12880 PLANK RD",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707144909",
            "telephone_number": "225-774-7111",
            "fax_number": "225-774-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12880 PLANK RD",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707144909",
            "telephone_number": "225-774-7111",
            "fax_number": "225-774-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK C MOUTON MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "MOUTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "CHRISTIAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "504-621-3298",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.201233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1090484",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ella G Mack, LPC-S
• Simone Maiden
• Yvonne Major, O.D.
• Kieara Malachi
• Ballard Jackson Mann, P.A.
• Nia Chantale Marsh
• Cody Marshall
• Consuela Marshall
• Karah Danielle Martin
• Madelyn Antle Martin, LMSW

• Internal Medicine Physician in Baker, LA
• Providers in Baker, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.