Organization Active NPI

LCMS Cardiovascular Diseases, LLC

  • Anesthesiology Physician
  • Lake Charles, LA
National Provider Identifier
1285869370
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
15-00013315 Issued in LA
Legal business name
LCMS CARDIOVASCULAR DISEASES, LLC
Practice address
2750 Aster St
Lake Charles, LA 70601-8824
Phone
(337) 480-8900
Fax
(337) 480-8901
NPI assigned
May 19, 2009
Organization subpart
Yes
Parent organization
LAKE CHARLES MEDICAL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Dawn Johnson-Hatcher
Title
Cfo
Phone
(337) 494-2094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 15-00013315 LA Primary

Addresses

Primary practice location

2750 Aster St
Lake Charles, LA 70601-8824

Mailing address

PO Box 122431
Dept 2431
Dallas, TX 75312-2431
Phone (337) 494-2921

Other identifiers 1

IdentifierTypeStateIssuer
2408569MedicaidLA

Other names 1

  • MMG Anesthesia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130703000206 LA Part B Supplier - Clinic/Group Practice 1951541515 Receives reassigned benefits from 45 practitioners
Practice locations: Lake Charles, LA

National Provider Directory

National Provider Directory
Part of
Family Medical Clinic S

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2750 Aster St
#B
Lake Charles, LA 70601
Phone (337) 480-8900

Practitioners & affiliated clinicians

Practitioners 48

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1285869370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122431",
            "address_2": "DEPT 2431",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122431",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 ASTER ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018824",
            "telephone_number": "337-480-8900",
            "fax_number": "337-480-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCMS CARDIOVASCULAR DISEASES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE CHARLES MEDICAL SERVICES, INC.",
        "enumeration_date": "2009-05-19",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-HATCHER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-494-2094"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "15-00013315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2408569",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMG Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MMG Anesthesia",
            "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 Dec 4, 2023; 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.