Individual provider Active NPI

Leon Ware Prejean, RNFA

  • Orthopedic Registered Nurse
  • Lake Charles, LA
National Provider Identifier
1376567602
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Registered NurseTaxonomy code 163WX0800X
License
RN033741 Issued in LA
Practice address
1717 Oak Park Blvd
3Rd Floor
Lake Charles, LA 70601-8991
Phone
(337) 494-4916
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Registered Nurse 163WX0800X RN033741 LA Primary

Addresses

Primary practice location

1717 Oak Park Blvd
3Rd Floor
Lake Charles, LA 70601-8991

Mailing address

1818 S Bend Rd
Lake Charles, LA 70605-0573
Phone (337) 474-3315

Other identifiers 1

IdentifierTypeStateIssuer
RN033741OtherLASTATE LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN033741LAMDOrthopedic Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376567602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 S BEND RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706050573",
            "telephone_number": "337-474-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD",
            "address_2": "3RD FLOOR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018991",
            "telephone_number": "337-494-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREJEAN",
        "first_name": "LEON",
        "middle_name": "WARE",
        "name_prefix": "Mr.",
        "credential": "RNFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "LA",
            "license": "RN033741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "RN033741",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 8, 2007; 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.