Individual provider Active NPI

Mary Cobb, DPM

  • Podiatrist
  • Leesville, LA
National Provider Identifier
1922454131
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
333207 Issued in LA
Practice address
1108 Port Arthur Ter
Leesville, LA 71446-4600
Phone
(337) 239-1061
NPI assigned
May 5, 2016
Last updated
Dec 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Podiatrist 213E00000X 333207 LA Primary
Podiatrist 213E00000X 016005825 IL

Addresses

Primary practice location

1108 Port Arthur Ter
Leesville, LA 71446-4600

Mailing address

1108 Port Arthur Ter
Leesville, LA 71446-4600
Phone (337) 239-1061

Other practice location 1

1428 E 69th St
Chicago, IL 60637-4804
Phone (312) 420-1227

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221115001845 LA Practitioner - Podiatry 3375979834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
R Franklin University of Med & Sci/Chicago Medical School, 2016
Medicare assignment
May accept Medicare assignment
Group practices
West Louisiana Health Services IncGroup PAC ID 5799680245, 9 clinicians
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians

Practice addresses (Care Compare)

1108 Port Arthur Ter
Leesville, LA 71446-4600
Phone (337) 239-1061

301 W Fertitta Blvd
Leesville, LA 71446-4665
Phone (337) 238-9931

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue65
Removal of skin lesions1-10
Removal of nail tissue619
Removal or shaving of skin growth94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016005825ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Louisiana Health Services Inc CurrentSince Nov 1, 2022 Accepting new patients
Hospital Service District No 2 of Parish of Beauregard State of la Current Accepting new patients
Housecall Doctors PC Podiatrist Past Accepting new patients
Beauregard Memorial Hospital Medical Staff Services Past Accepting new patients

Locations

200 W 5th St
Deridder, LA 70634
Phone (337) 221-1417

600 S Pine St
Deridder, LA 70634
Phone (337) 462-7100

1108 Port Arthur Ter
Leesville, LA 71446
Phone (337) 239-1061

Interoperability endpoints

  • Direct secure messaging: mary.cobb@beauregard.medalliesdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1922454131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 PORT ARTHUR TER",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464600",
            "telephone_number": "337-239-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 PORT ARTHUR TER",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464600",
            "telephone_number": "337-239-1061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1428 E 69th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606374804",
            "country_code": "US",
            "telephone_number": "312-420-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBB",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-05",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "333207",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005825",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.