MS. LATRICE SHONTA MALLARD MAM, APRN, PMHNP-BC
NPI 1225565807
Nurse Practitioner - Psychiatric/Mental Health in Kentwood, LA

Q: What is Latrice Mallard's NPI number?

The NPI number for Latrice Mallard is 1225565807. It was assigned to this individual provider in the NPPES registry on May 15, 2017.

Q: What is Latrice Mallard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Latrice Mallard was last updated on April 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 15, 2017PECOS EnrolledAccepts Medicare Assignment

721 AVENUE G, KENTWOOD, LA 70444(225) 315-1357 Get Directions Write a Review

NPPES record last updated: April 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 13, 2023, Mar 17, 2018, May 15, 2017 (3 updates tracked since 2017).

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About Ms. Latrice Shonta Mallard Mam, Aprn, Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. LATRICE SHONTA MALLARD MAM, APRN, PMHNP-BC (NPI 1225565807) is an individual psychiatric/mental health provider in Kentwood, Louisiana, licensed in Louisiana (229471) and active in the NPI registry since May 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Baton Rouge, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1225565807

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMS. LATRICE SHONTA MALLARDCredential: MAM, APRN, PMHNP-BC

Location Address721 AVENUE GKentwood, LA 70444-2601

Mailing AddressPo Box 40984Baton Rouge, LA 70835-0984 · (225) 315-1357

Phone(225) 315-1357

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateMay 15, 2017

Last NPPES UpdateApril 13, 20233 updates tracked since enumeration

NPPES CertifiedApril 13, 2023

✔ NPI 1225565807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in LA · 229471

Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License 117290 (LA)

721 AVENUE G, Kentwood, LA 70444

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Secondary Practice Location 1

Location 1711 Colonial Dr Ste DBaton Rouge, LA 70806-6549 · Phone (225) 246-2162

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Latrice Shonta Mallard Mam, Aprn, Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880138189

PECOS Enrollment IDI20240627002088

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 70444 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.60 typical visit price

range $53.43 – $164.73

Typical copayment $20.90 (range $13.35 – $41.18)

Most-billed visit code 99203

Established Patient

$95.09 typical visit price

range $16.64 – $133.62

Typical copayment $23.77 (range $4.16 – $33.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIZZY WOODS NP

Nurse Practitioner (Family)