NPIMap

Organization Active NPI

Imperial Health, LLP

  • Family Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1053352401
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IMPERIAL HEALTH, LLP
Practice address
501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone
(337) 433-8400
Fax
(337) 312-6708
NPI assigned
Jun 9, 2006
Last updated
Jan 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Authorized official

Name
Tonya Richard
Title
Assistant Administrator
Phone
(337) 312-8291

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Gastroenterology Physician 207RG0100X
Pulmonary Disease Physician 207RP1001X
Rheumatology Physician 207RR0500X
Orthopaedic Surgery Physician 207X00000X
Otolaryngology Physician 207Y00000X
Physical Medicine & Rehabilitation Physician 208100000X
Diagnostic Radiology Physician 2085R0202X
Surgery Physician 208600000X
Surgery of the Hand (Surgery) Physician 2086S0105X
Foot Surgery Podiatrist 213ES0131X

Addresses

Primary practice location

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 433-8400

Other identifiers 1

IdentifierTypeStateIssuer
1016314MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040108000257 LA Part B Supplier - Clinic/Group Practice 7719886779 Receives reassigned benefits from 83 practitioners
Practice locations: Lake Charles, LA; Sulphur, LA; Dequincy, LA; Deridder, LA; Jennings, LA; Kinder, LA; Lafayette, LA
O20100930085282 LA DME Supplier - Physician - General PracticeDME Supplier - Physician - General Surgery 7719886779 Practice locations: Lake Charles, LA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

1920 W Sale Rd
Ste 2
Lake Charles, LA 70605
Phone (337) 312-8284

4150 Nelson Rd
Ste G3
Lake Charles, LA 70605
Phone (337) 562-3732

4201 Nelson Rd
Ste 100
Lake Charles, LA 70605
Phone (337) 310-2273

600 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 439-5800

277 N Highway 171
Ste 8
Moss Bluff, LA 70611
Phone (337) 312-0030

Practitioners & affiliated clinicians

Practitioners 83

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 83

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484524800000",
    "number": "1053352401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-433-8400",
            "fax_number": "337-312-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-433-8400",
            "fax_number": "337-312-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL HEALTH, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-01-16",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "337-312-8291"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016314",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.