Mallory Leblanc Pfaffly, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME177427 Issued in FL

Practice address

504 NE Cholokka Blvd
Micanopy, FL 32667-4109

Phone

(352) 619-9526

Fax

(352) 265-9584

NPI assigned

Apr 2, 2024

Last updated

Mar 31, 2026By 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

• Dr. Mallory Anne Leblanc Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1881446052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 NE CHOLOKKA BLVD",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326674109",
            "telephone_number": "352-619-9526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 NE CHOLOKKA BLVD",
            "city": "MICANOPY",
            "state": "FL",
            "postal_code": "326674109",
            "telephone_number": "352-619-9526",
            "fax_number": "352-265-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFAFFLY",
        "first_name": "MALLORY",
        "middle_name": "LEBLANC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME177427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "LEBLANC",
            "middle_name": "ANNE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Hager
• Kelly Marie Johnston, RD
• Eric Lanham
• Anna Belen Larson, LM, CPM
• McIntosh Assisted Living
• Caroline Roach, LCSW
• Irina Shlain, L.AC. A.P.
• Snickers&Giggles

• General Practice Physician in Micanopy, FL
• Providers in Micanopy, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; 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.