Individual provider Active NPI

Mignonne C. Mary, M.D.

  • Obesity Medicine (Internal Medicine) Physician
  • New Orleans, LA
National Provider Identifier
1770611576
Registry record updated Aug 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
024324 Issued in LA
Practice address
1224 Saint Charles Ave
Suite 1-C
New Orleans, LA 70130-4334
Phone
(504) 301-1670
Fax
(504) 309-4413
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) Physician 207RB0002X 024324 LA Primary
Internal Medicine Physician 207R00000X 024324 LA

Addresses

Primary practice location

1224 Saint Charles Ave
Suite 1-C
New Orleans, LA 70130-4334

Mailing address

1224 Saint Charles Ave
Suite 1-C
New Orleans, LA 70130-4334
Phone (504) 301-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
024324LAMDObesity Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375488000000",
    "number": "1770611576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 SAINT CHARLES AVE",
            "address_2": "SUITE 1-C",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701304334",
            "telephone_number": "504-301-1670",
            "fax_number": "504-309-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 SAINT CHARLES AVE",
            "address_2": "SUITE 1-C",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701304334",
            "telephone_number": "504-301-1670",
            "fax_number": "504-309-4413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARY",
        "first_name": "MIGNONNE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2013-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "LA",
            "license": "024324",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "024324",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.