NPIMap

Organization Active NPI

Lake Urgent Care Ascension LLC

Doing business as Lake Urgent Care - Gonzales

  • Urgent Care Clinic/Center
  • Gonzales, LA
National Provider Identifier
1477899656
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LAKE URGENT CARE ASCENSION LLC
Doing business as
Lake Urgent Care - Gonzales
Practice address
1702 N Burnside Ave
Gonzales, LA 70737-2141
Phone
(225) 647-4988
NPI assigned
Dec 17, 2012
Last updated
Jan 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Authorized official

Name
Steve Sellars
Title
President
Phone
(225) 214-9353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1702 N Burnside Ave
Gonzales, LA 70737-2141

Mailing address

PO Box 679641
Dallas, TX 75267-9641

Other names 1

  • Lake Urgent Care - Gonzales Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130627000023 LA Part B Supplier - Clinic/Group Practice 0244479095 Receives reassigned benefits from 154 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gonzales, LA; Prairieville, LA; Saint Amant, LA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674518400000",
    "number": "1477899656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 679641",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752679641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 N BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707372141",
            "telephone_number": "225-647-4988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE URGENT CARE ASCENSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-17",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A",
        "authorized_official_last_name": "SELLARS",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-214-9353"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Urgent Care - Gonzales",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Urgent Care - Gonzales",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.