Active NPI 1164816831 Individual Practitioner Female Practitioner

Mallory Bourg

Physician Assistant • Baton Rouge, LA

Professional Overview & Biography Verified Profile Summary

Mallory Bourg is a registered healthcare professional specializing in Physician Assistant in Baton Rouge, LA. Practice services are available at 7777 HENNESSY BLVD under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, injection, dexamethasone sodium phosphate, 1 mg, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7777 Hennessy Blvd
Suite 701

Baton Rouge, LA 708084300

Telephone 2257655864

Fax 2257652013

Associated Practice Facility / Clinic

🏢 Our Lady Of The Lake Facility NPI 1851391148

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Baton Rouge, LA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.1 Yrs

State Avg: 10.0 Yrs

Regional Practice Density

327 Specialists

Practicing in Baton Rouge, LA (1565 Statewide)

Telehealth Adoption Rate

7.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

58.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$172.00	$71.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1100 Injection, dexamethasone sodium phosphate, 1 mg	105	11	$3.00	$0.12
99213 Established patient office or other outpatient visit, typically 15 minutes	51	50	$122.00	$70.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	33	33	$182.00	$89.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	27	26	$180.00	$102.02
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	23	23	$55.00	$50.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	19	$40.00	$11.12
81003 Automated urinalysis test	13	13	$10.00	$2.05
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$276.00	$133.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1100 Injection, dexamethasone sodium phosphate, 1 mg	190	20	$3.00	$0.12
99213 Established patient office or other outpatient visit, typically 15 minutes	67	67	$122.00	$73.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	32	32	$182.00	$91.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	31	$180.00	$104.06
87804 Detection test by immunoassay with direct visual observation for influenza virus	30	15	$35.00	$16.30
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	29	29	$55.00	$50.76
87811 Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19)	27	27	$50.00	$40.92
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	26	24	$40.00	$11.45
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$276.00	$137.40
87502 Detection test by nucleic acid for multiple types influenza virus	13	13	$174.00	$94.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	11	11	$180.00	$101.22

Medical Specialties & State Licenses

CMS Verified: 2023-09-29

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License LA 200789

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Dr. Jennifer Rippon , DO

Internal Medicine - Pulmonary Disease

NPI 1003020348

Doctor of Osteopathic Medicine (D.O.)

Pamela Stanley , NP

Nurse Practitioner - Acute Care

NPI 1003273574

Nurse Practitioner

Laura Knight , PA

Physician Assistant - Medical

NPI 1053973750

Physician Assistant

Dr. Alexandra Perry , MD

Internal Medicine - Critical Care Medicine

NPI 1063733855

Doctor of Medicine (M.D.)

Dr. Melanie Mcknight , MD

Hospitalist

NPI 1073546149

Doctor of Medicine (M.D.)

Dr. Kara Ward , MD

Internal Medicine - Critical Care Medicine

NPI 1073756227

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

👤

Provider Name / Credentials Updated September 29, 2023

Recorded as MALLORY BOURG

✅

NPI Profile Active June 14, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location June 14, 2016

Registered at 7777 HENNESSY BLVD, SUITE 701, BATON ROUGE, LA 708084300 (Tel: 2257655864)

📍

Updated Business Mailing Address June 14, 2016

Registered at 5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 708166038 (Tel: 2255260006)

👤

Provider Name / Credentials Updated June 14, 2016

Recorded as MALLORY LUDWIG

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 14, 2016

Physician Assistant (License #200789 in LA)

🟢

Initial NPI Registration & Enumeration March 20, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164816831

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 20, 2015

Last Update: September 29, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

5959 S Sherwood Forest Blvd

Baton Rouge, LA 708166038

Phone: 2255260006

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.