Individual provider Active NPI

Kristen Marcantel, MS

  • Speech-Language Pathologist
  • Lake Charles, LA
National Provider Identifier
1710484944
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7669 Issued in LA
Practice address
1727 Imperial Blvd BLDG 3
Lake Charles, LA 70605-5362
Phone
(337) 478-5880
Fax
(337) 478-5879
NPI assigned
Apr 13, 2018
Last updated
Apr 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7669 LA Primary

Addresses

Primary practice location

1727 Imperial Blvd BLDG 3
Lake Charles, LA 70605-5362

Mailing address

1727 Imperial Blvd BLDG 3
Lake Charles, LA 70605-5362
Phone (337) 478-5880

Other identifiers 1

IdentifierTypeStateIssuer
7669OtherLASPEECH-LANGUAGE PATHOLOGY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180507000525 LA Practitioner - Qualified Speech Language Pathologist 3779847314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Therapy Center, LLCGroup PAC ID 9931275377, 12 clinicians

Practice addresses (Care Compare)

1727 Imperial Blvd
BLDG 3
Lake Charles, LA 70605-5393
Phone (337) 478-5880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7669LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Therapy Center, LLC Speech-Language Pathologist CurrentSince Apr 16, 2018 Accepting new patients

Locations

1727 Imperial Blvd
Bldg 3
Lake Charles, LA 70605
Phone (337) 478-5800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1710484944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 IMPERIAL BLVD BLDG 3",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-478-5880",
            "fax_number": "337-478-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 IMPERIAL BLVD BLDG 3",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-478-5880",
            "fax_number": "337-478-5879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCANTEL",
        "first_name": "KRISTEN",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "7669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGY",
            "identifier": "7669",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Apr 13, 2018; 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.