NPIMap

Organization Active NPI

Calcasieu Urgent Care LLC

  • Specialist
  • Baker, LA
National Provider Identifier
1063082956
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CALCASIEU URGENT CARE LLC
Practice address
902 Main St
Baker, LA 70714-3444
Phone
(901) 351-1791
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Sydni Clemmons
Title
Credentialing Manager
Phone
(901) 351-1791

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

902 Main St
Baker, LA 70714-3444

Mailing address

PO Box 306416
Nashville, TN 37230-6416
Phone (901) 351-1791

Other identifiers 1

IdentifierTypeStateIssuer
0000OtherLAMEDICAID PENDING

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2232161Calcasieu Urgent Care, LLC902 Main Street, Baker, LA 70714Certificate of waiverAug 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Calcasieu Urgent Care LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

902 Main St
Baker, LA 70714
Phone (225) 500-2504

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1063082956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306416",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306416",
            "telephone_number": "901-351-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 MAIN ST",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707143444",
            "telephone_number": "901-351-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALCASIEU URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "CLEMMONS",
        "authorized_official_first_name": "SYDNI",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-351-1791"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PENDING",
            "identifier": "0000",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baker, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.