NPIMap

Organization Active NPI

Lake Charles Medical Services Family Practice Associates, LLC

Doing business as Family Medicine Specialists

  • Family Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1396926069
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKE CHARLES MEDICAL SERVICES FAMILY PRACTICE ASSOCIATES, LLC
Doing business as
Family Medicine Specialists
Practice address
2750 Aster St
Lake Charles, LA 70601-8824
Phone
(337) 480-8900
Fax
(337) 480-8901
NPI assigned
Nov 21, 2007
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LAKE CHARLES MEDICAL SERVICES, INCAs 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Interventional Pain Medicine Physician 208VP0014X NU

Addresses

Primary practice location

2750 Aster St
Lake Charles, LA 70601-8824

Mailing address

PO Box 122539 Dept 2539
Dallas, TX 75312-2539
Phone (337) 494-2921

Other practice location 1

1890 W Gauthier Rd Ste 155
Lake Charles, LA 70605-7119
Phone (337) 480-5550

Other practice location 2

2900 2nd Ave
Lake Charles, LA 70601-8906
Phone (337) 480-8994

Other practice location 3

217 Sam Houston Jones Pkwy Ste 104
Lake Charles, LA 70611-5644
Phone (337) 480-8989

Other identifiers 2

IdentifierTypeStateIssuer
1048429MedicaidLA
0700011544OtherLAOCCUPATIONAL LICENSE/MOUT

Other names 1

  • Family Medicine Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080610000427 LA Part B Supplier - Clinic/Group Practice 1052481504 Receives reassigned benefits from 28 practitioners
Practice locations: Lake Charles, LA; Sulphur, LA; Welsh, LA; Creole, LA

National Provider Directory

National Provider Directory
Part of
Family Medical CL of Su

Member of 1

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

Locations

217 Sam Houston Jones Pkwy
Ste 104
Lake Charles, LA 70611
Phone (337) 480-8989

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

2800 2nd Ave
Ste C
Lake Charles, LA 70601
Phone (337) 474-2082

Practitioners & affiliated clinicians

Practitioners 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1396926069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122539 DEPT 2539",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122539",
            "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": [
        {
            "address_1": "1890 W Gauthier Rd Ste 155",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706057119",
            "country_code": "US",
            "telephone_number": "337-480-5550",
            "fax_number": "337-480-5568",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2900 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706018906",
            "country_code": "US",
            "telephone_number": "337-480-8994",
            "fax_number": "337-480-8993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 Sam Houston Jones Pkwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706115644",
            "country_code": "US",
            "telephone_number": "337-480-8989",
            "fax_number": "337-480-8988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE CHARLES MEDICAL SERVICES FAMILY PRACTICE ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE CHARLES MEDICAL SERVICES, INC",
        "enumeration_date": "2007-11-21",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1048429",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL LICENSE/MOUT",
            "identifier": "0700011544",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Medicine Specialists",
            "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.