Individual provider Active NPI

Lisa Marie Church, NP

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1356089148
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223797 Issued in LA
Practice address
1890 W Gauthier Rd Ste 135
Lake Charles, LA 70605-7179
Phone
(337) 480-5510
Fax
(337) 480-5511
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 223797 LA Primary

Addresses

Primary practice location

1890 W Gauthier Rd Ste 135
Lake Charles, LA 70605-7179

Mailing address

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897
Phone (985) 446-5079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221013000148 LA Practitioner - Nurse Practitioner 6204202419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Ear, Nose, and Throat Specialists, Inc.Group PAC ID 0042313504, 65 clinicians

Practice addresses (Care Compare)

1890 W Gauthier Rd
Suite 150
Lake Charles, LA 70605-7119
Phone (337) 480-5559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
223797LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LCMS Obstetrics and Gynecology LLC CurrentSince Feb 20, 2023 Accepting new patients
Louisiana Ear, Nose, & Throat Specialists, Inc. CurrentSince Dec 8, 2025 Accepting new patients

Locations

1890 W Gauthier Rd
Ste 205
Lake Charles, LA 70605
Phone (337) 480-5595

1890 W Gauthier Rd
Ste 150
Lake Charles, LA 70605
Phone (337) 480-5559

1890 W Gauthier Rd
Ste 135
Lake Charles, LA 70605
Phone (337) 480-5510

604 N Acadia Rd
Ste 101
Thibodaux, LA 70301
Phone (985) 446-5079

Interoperability endpoints

  • Direct secure messaging: lchurch5281988@direct.casso.us.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1356089148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897",
            "telephone_number": "985-446-5079",
            "fax_number": "985-447-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 W GAUTHIER RD STE 135",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706057179",
            "telephone_number": "337-480-5510",
            "fax_number": "337-480-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "223797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.