NPIMap

Organization Active NPI

Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Lake Charles, LA
National Provider Identifier
1043472202
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
Practice address
2802 Pineview St
Lake Charles, LA 70615-2063
Phone
(337) 217-4540
Fax
(337) 439-5029
NPI assigned
Jun 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Mr. Paul Trevino
Title
Ceo
Phone
(337) 491-7730

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

2802 Pineview St
Lake Charles, LA 70615-2063

Mailing address

524 Dr Michael Debakey Dr
Lake Charles, LA 70601-5725
Phone (337) 217-4540

Other identifiers 1

IdentifierTypeStateIssuer
1447153MedicaidLA

Other names 1

  • WASHINGTON-MARION SBHC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Patrick Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1043472202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015725",
            "telephone_number": "337-217-4540",
            "fax_number": "337-439-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 PINEVIEW ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706152063",
            "telephone_number": "337-217-4540",
            "fax_number": "337-439-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH SOUTHWESTERN LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-30",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-491-7730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447153",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WASHINGTON-MARION SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.