Mallory Sparacello Sotile, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

226268 Issued in LA

Practice address

163 Burgin Ave
Baton Rouge, LA 70808-4925

Phone

(225) 313-4560

NPI assigned

Aug 3, 2022

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

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

W Trent Massengale MD LLCGroup PAC ID 3173762283, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• W Trent Massengale, MD LLC

  • Dermatology Physician
  • Prairieville, LA
  • NPI 1255774287
  Medicare reassignment Care Compare group NPD
• Healthcare Plus Limited Liability Company

  • Specialist
  • Metairie, LA
  • NPI 1063927465
  Medicare reassignment NPD
• Wound Management Specialists, LLC

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1972150084

  LA

  Medicare reassignment NPD

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1841927431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6558 CLARK PLANTATION DR",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707378595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 BURGIN AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084925",
            "telephone_number": "225-313-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17503 Old Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "Prairieville",
            "state": "LA",
            "postal_code": "707693930",
            "country_code": "US",
            "telephone_number": "225-313-4560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTILE",
        "first_name": "MALLORY",
        "middle_name": "SPARACELLO",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "226268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corey A Sorrel, RPH
• Marcie Leanne Sorrel
• Melissa Ann Sorrells, LAT, ATC
• Sierra Sossamon, MD
• Caroline Sotile, MS, CGC
• Sara Sotile, LCSW-BACS
• Stephanie Elise Sotile, DDS
• Steven Charles Sotile, M.D.
• Steven Soto
• Somar Soufan, M.D.

• Family Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.