NPIMap

Organization Active NPI

LCMS Surgical Associates of Southwest Lousiana, LLC

Doing business as Surgical Associates of Southwest Louisiana

  • Surgery Physician
  • Lake Charles, LA
National Provider Identifier
1407168032
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
10-00013733 Issued in LA
Legal business name
LCMS SURGICAL ASSOCIATES OF SOUTHWEST LOUSIANA, LLC
Doing business as
Surgical Associates of Southwest Louisiana
Practice address
2770 3Rd Ave
Suite 120
Lake Charles, LA 70601-8994
Phone
(337) 494-4868
Fax
(337) 494-4870
NPI assigned
Jul 12, 2010
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 10-00013733 LA Primary

Addresses

Primary practice location

2770 3Rd Ave
Suite 120
Lake Charles, LA 70601-8994

Mailing address

PO Box 122342, Dept 2342
Dallas, TX 75312-0001
Phone (337) 494-2921

Other identifiers 1

IdentifierTypeStateIssuer
10-00013733OtherLAOCCUPATIONAL LICENSE

Other names 1

  • Surgical Associates of Southwest Louisiana Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100915000594 LA Part B Supplier - Clinic/Group Practice 8820113780 Receives reassigned benefits from 10 practitioners
Practice locations: Lake Charles, LA

National Provider Directory

National Provider Directory
Part of
Leesville Health Center

Locations

2770 3rd Ave
Ste 120
Lake Charles, LA 70601
Phone (337) 494-4868

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1407168032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122342, DEPT 2342",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "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": "2770 3RD AVE",
            "address_2": "SUITE 120",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018994",
            "telephone_number": "337-494-4868",
            "fax_number": "337-494-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCMS SURGICAL ASSOCIATES OF SOUTHWEST LOUSIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE CHARLES MEDICAL SERVICES, INC",
        "enumeration_date": "2010-07-12",
        "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": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "LA",
            "license": "10-00013733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL LICENSE",
            "identifier": "10-00013733",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Associates of Southwest Louisiana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Surgical Associates of Southwest Louisiana",
            "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.