NPIMap

Organization Active NPI

Minor Medical Clinic LLC

  • Health Service Clinic/Center
  • Lake Charles, LA
National Provider Identifier
1720008675
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MINOR MEDICAL CLINIC LLC
Practice address
109 Executive Dr.
Suite C
Lake Charles, LA 70611-5328
Phone
(337) 217-0922
Fax
(337) 217-0925
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Karen Marie Whitehead, ARPN
Title
Family Nurse Practitioner
Phone
(337) 217-0922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X LA Primary

Addresses

Primary practice location

109 Executive Dr.
Suite C
Lake Charles, LA 70611-5328

Mailing address

109 Executive Dr.
Suite C
Lake Charles, LA 70611-5328
Phone (337) 217-0922

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1720008675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 EXECUTIVE DR.",
            "address_2": "SUITE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115328",
            "telephone_number": "337-217-0922",
            "fax_number": "337-217-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 EXECUTIVE DR.",
            "address_2": "SUITE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706115328",
            "telephone_number": "337-217-0922",
            "fax_number": "337-217-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOR MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "WHITEHEAD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "337-217-0922",
        "authorized_official_credential": "ARPN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.