NPIMap

Organization Active NPI

Christus Health Southwestern Louisiana

  • Neurological Surgery Physician
  • Lake Charles, LA
National Provider Identifier
1104267301
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
647 Issued in LA
Legal business name
CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
Practice address
1614 Wolf Cir
Lake Charles, LA 70605-2348
Phone
(337) 478-9653
Fax
(337) 474-0988
NPI assigned
Jul 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Authorized official

Name
Mr. Stephen Wright
Title
Ceo
Phone
(337) 448-6584

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X 647 LA Primary

Addresses

Primary practice location

1614 Wolf Cir
Lake Charles, LA 70605-2348

Mailing address

524 Dr Michael Debakey Dr
Lake Charles, LA 70601-5725
Phone (337) 491-7730

Other identifiers 1

IdentifierTypeStateIssuer
1720241MedicaidLA

Other names 1

  • CHRISTUS ST PATRICK HOSPITAL NEUROSURGICAL ASSOCIATES 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": "1373932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373932800000",
    "number": "1104267301",
    "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": "337-491-7730",
            "fax_number": "337-491-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 WOLF CIR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052348",
            "telephone_number": "337-478-9653",
            "fax_number": "337-474-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH SOUTHWESTERN LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-16",
        "last_updated": "2013-07-16",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-448-6584",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720241",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS ST PATRICK HOSPITAL NEUROSURGICAL ASSOCIATES",
            "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 16, 2013; 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.