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Organization Active NPI

Christus Health Southwestern Louisiana

  • Student Health Clinic/Center
  • Grand Chenier, LA
National Provider Identifier
1407068299
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
Practice address
753 Oak Grove Hwy
Grand Chenier, LA 70643-3242
Phone
(337) 542-4441
Fax
(337) 542-4588
NPI assigned
May 4, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Paul Trevino
Title
Ceo
Phone
(409) 899-8191

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 6

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

Affiliated clinicians 330

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 330

Care Compare: Hospital

Medicare Care Compare
Listed as
Christus Ochsner St Patrick HospitalCCN 190027
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Medicare participation

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

Hospital certification: CCN 190027

Medicare enrollment files
Legal name
CHRISTUS HEALTH SOUTHWESTERN LOUISIANA
Doing business as
CHRISTUS OCHSNER ST PATRICK HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 27, 2025
Beds
230
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Apr 11, 1921 in LA
Enrollment address
524 Dr Michael Debakey Dr
Lake Charles, LA 70601-5725
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 10

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Matthew Block Individual Corporate DirectorBoard Member Jan 1, 2024
Christus Health Organization, Irving, TX Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Feb 1, 1999 60%
James F Davidson Individual Corporate OfficerPresident & Coo Feb 1, 2021
W-2 Managing EmployeePresident & Coo Feb 1, 2021
Charles D Daigle Individual Corporate DirectorBoard Member Jan 1, 2023
Ochsner Clinic Foundation Organization, New Orleans, LA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 1, 2018 40%
Dennis Stine Individual Corporate Director Sep 1, 2018
Sonia Acosta Individual Corporate DirectorCorporate Secretary Sep 16, 2024
Monte Wilson Individual Corporate OfficerCeo Oct 1, 2025
Corporate Director Oct 1, 2025
Nikki Martin Individual Corporate OfficerCfo Jun 22, 2021
Fadi V Nasrallah Individual Corporate DirectorBoard Member Feb 22, 2024

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040702000393 LA Part a Provider - Hospital 5799695839 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lake Charles, LA

National Provider Directory

National Provider Directory

Locations

753 Oak Grove Hwy
Grand Chenier, LA 70643
Phone (337) 542-4441

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

NPPES NPI Registry

Primary practice location

753 Oak Grove Hwy
Grand Chenier, LA 70643-3242

Mailing address

524 Dr Michael Debakey Dr
Lake Charles, LA 70601-5725
Phone (337) 542-4441

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1447404MedicaidLA

Other names 1

NPPES NPI Registry
  • SOUTH CAMERON HIGH SBHC Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 5, 2022.

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1407068299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015725",
            "telephone_number": "337-542-4441",
            "fax_number": "337-542-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 OAK GROVE HWY",
            "city": "GRAND CHENIER",
            "state": "LA",
            "postal_code": "706433242",
            "telephone_number": "337-542-4441",
            "fax_number": "337-542-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH SOUTHWESTERN LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "409-899-8191"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447404",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH CAMERON HIGH SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Chenier, LA

Sources for this page

Verify at the official NPI Registry.