Individual provider Active NPI

Mallory Dubois, RN

  • Family Nurse Practitioner
  • Concord, NH
National Provider Identifier
1871842609
Registry record updated Dec 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
066476-23 Issued in NH
Practice address
36 Clinton St
Concord, NH 03301-2359
Phone
(603) 271-5300
NPI assigned
Sep 7, 2012
Last updated
Dec 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2025

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 066476-23 NH Primary

Addresses

Primary practice location

36 Clinton St
Concord, NH 03301-2359

Mailing address

36 Clinton St
Concord, NH 03301-2359

Other names 1

  • Mallory Lavigne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20260406002739 NH Practitioner - Nurse Practitioner 0749755973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of New HampshireGroup PAC ID 3870530579, 77 clinicians

Practice addresses (Care Compare)

36 Clinton St
Concord, NH 03301-2359
Phone (603) 271-5300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
066476-23NHMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766275200000",
    "number": "1871842609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CLINTON ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CLINTON ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012359",
            "telephone_number": "603-271-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "MALLORY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-07",
        "last_updated": "2025-12-21",
        "certification_date": "2025-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "066476-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "LAVIGNE",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.