NPIMap

Individual provider Active NPI

Catherine Drez Self, CCC-A

  • Audiologist
  • Lake Charles, LA
National Provider Identifier
1376808774
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3252 Issued in LA
Practice address
314 Broad St
Suite B
Lake Charles, LA 70601-4224
Phone
(337) 491-0800
Fax
(337) 491-0508
NPI assigned
Jul 11, 2012
Last updated
Jul 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3252 LA Primary

Addresses

Primary practice location

314 Broad St
Suite B
Lake Charles, LA 70601-4224

Mailing address

314 Broad St
Suite B
Lake Charles, LA 70601-4224
Phone (337) 491-0800

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
3252LAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Nicholas Center for Early Intervention Past Accepting new patients
St. Nicholas Center for Children Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1376808774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 BROAD ST",
            "address_2": "SUITE B",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706014224",
            "telephone_number": "337-491-0800",
            "fax_number": "337-491-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 BROAD ST",
            "address_2": "SUITE B",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706014224",
            "telephone_number": "337-491-0800",
            "fax_number": "337-491-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "CATHERINE",
        "middle_name": "DREZ",
        "name_prefix": "Mrs.",
        "credential": "CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "LA",
            "license": "3252",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 17, 2012; 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.