Individual provider Active NPI

Carlee Theriot Carroll, APRN, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1710527650
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
210944 Issued in LA
Practice address
4345 Nelson Rd Ste 101
Lake Charles, LA 70605-4183
Phone
(337) 480-7942
Fax
(337) 494-7964
NPI assigned
Jan 8, 2020
Last updated
Jun 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11040195 FL
Family Nurse Practitioner 363LF0000X 210944 LA Primary

Addresses

Primary practice location

4345 Nelson Rd Ste 101
Lake Charles, LA 70605-4183

Mailing address

PO Box 122165 Dept 2165
Dallas, TX 75312-0001
Phone (373) 494-2772

Other practice location 1

230 W Sale Rd
Lake Charles, LA 70605-2828
Phone (337) 477-5252

Other practice location 2

1717 Oak Park Blvd Fl 3
Lake Charles, LA 70601-8990
Phone (374) 944-9063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230331000798 LA Practitioner - Nurse Practitioner 5092180224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Charles Medical Services Orthopedics Associates LLCGroup PAC ID 9638265697, 13 clinicians

Practice addresses (Care Compare)

1717 Oak Park Blvd
FL 3
Lake Charles, LA 70601-8990
Phone (337) 494-4900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11040195FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Medical Services Orthopedics Associates LLC CurrentSince Mar 13, 2023 Accepting new patients
MMG Nelson Rd LLC PastSince Jun 23, 2025 Accepting new patients
Sulphur Pediatric Clinic Medical Corporation PastSince Jan 1, 2020 Accepting new patients

Locations

1717 Oak Park Blvd
Fl 3
Lake Charles, LA 70601
Phone (337) 494-4900

230 W Sale Rd
Lake Charles, LA 70605
Phone (337) 477-5252

4345 Nelson Rd
Lake Charles, LA 70605
Phone (337) 480-7900

4345 Nelson Rd
Ste 101
Lake Charles, LA 70605
Phone (337) 480-7942

Interoperability endpoints

  • Direct secure messaging: ccarroll5281976@direct.casso.us.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1710527650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122165 DEPT 2165",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "373-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 NELSON RD STE 101",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054183",
            "telephone_number": "337-480-7942",
            "fax_number": "337-494-7964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 W Sale Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706052828",
            "country_code": "US",
            "telephone_number": "337-477-5252",
            "fax_number": "337-502-5069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 Oak Park Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706018990",
            "country_code": "US",
            "telephone_number": "374-944-9063",
            "fax_number": "337-494-4936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CARLEE",
        "middle_name": "THERIOT",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11040195",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "210944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.