Impact Health & Wellness Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IMPACT HEALTH & WELLNESS LAB, LLC

Practice address

3443 Waterview Dr
Lake Charles, LA 70607-1006

Phone

(337) 884-4934

NPI assigned

Feb 3, 2022

Last updated

Feb 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristie Pete, RNNPI 1952053415

Title

Director

Phone

(337) 884-4934

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Kristie Pete, RN

  • Registered Nurse
  • Lake Charles, LA
  • NPI 1952053415
  NPD Authorized official

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1184378648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 WATERVIEW DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706071006",
            "telephone_number": "337-884-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 WATERVIEW DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706071006",
            "telephone_number": "337-884-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HEALTH & WELLNESS LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "PETE",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "337-884-4934",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mecah A Idikwu, NP
• Ieyoub Enterprises, LLC (Premier Internal Medicine)
• Susan Bourgeois Ieyoub, MD
• William L. Iglinsky, M.D.
• Iles Medical Testing,LLC
• Impact Physician Group, Louisiana LLC
• Impact Physician Group, Pediatrics LLC
• Imperial Calcasieu Human Services Authority (LCBHC Childrens Outreach Services)
• Imperial Calcasieu Human Services Authority (ImCal Primary Care)
• Imperial Calcasieu Human Services Authority (ImCal BH Lake Charles)

• Clinical Medical Laboratory in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Clinical Medical Laboratory in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.