NPIMap

Organization Active NPI

Lake Charles Memorial Heart and Vascular Center

Doing business as Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Lake Charles, LA
National Provider Identifier
1407808405
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER
Doing business as
Heart & Vascular Center
Practice address
1717 Oak Park Blvd FL 2
Lake Charles, LA 70601-8990
Phone
(337) 494-3278
Fax
(337) 494-3240
NPI assigned
May 17, 2006
Last updated
Mar 25, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST LOUISIANA HEALTH CARE SYSTEM, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X LA Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X LA

Addresses

Primary practice location

1717 Oak Park Blvd FL 2
Lake Charles, LA 70601-8990

Mailing address

PO Box 122152, Dept 2152 Dept 2152
Dallas, TX 75312-2152
Phone (337) 494-2921

Other practice location 1

913 E Kent Dr
Sulphur, LA 70663-5007
Phone (337) 494-3278

Other practice location 2

109 W 4th St
Deridder, LA 70634-4849
Phone (337) 494-3278

Other practice location 3

1322 Elton Rd Ste E
Jennings, LA 70546-4100
Phone (337) 494-3278

Other practice location 4

122 W 4th St
Dequincy, LA 70633-3508
Phone (337) 494-3278

Other names 1

  • HEART & VASCULAR CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040901001355 LA Part B Supplier - Clinic/Group Practice 4082689914 Receives reassigned benefits from 16 practitioners
Practice locations: Sulphur, LA; Lake Charles, LA; Jennings, LA; Deridder, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0875355Heart and Vascular Center1717 Oak Park Boulevard, Second Floor, Lake Charles, LA 70601Certificate of waiverDec 22, 2027

National Provider Directory

National Provider Directory

Locations

619 S Huntington St
Sulphur, LA 70663
Phone (337) 494-3278

913 E Kent Dr
Sulphur, LA 70663
Phone (337) 527-3610

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1407808405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122152, DEPT 2152 DEPT 2152",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122152",
            "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": "1717 OAK PARK BLVD FL 2",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018990",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 E Kent Dr",
            "address_purpose": "LOCATION",
            "city": "Sulphur",
            "state": "LA",
            "postal_code": "706635007",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Deridder",
            "state": "LA",
            "postal_code": "706344849",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1322 Elton Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Jennings",
            "state": "LA",
            "postal_code": "705464100",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "122 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Dequincy",
            "state": "LA",
            "postal_code": "706333508",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE CHARLES MEMORIAL HEART AND VASCULAR CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST LOUISIANA HEALTH CARE SYSTEM, INC",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "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": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEART & VASCULAR CENTER",
            "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 Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.