Individual provider Active NPI

Anissa M Disnuke, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1730979584
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
240295 Issued in LA
Practice address
4200 Nelson Rd
Lake Charles, LA 70605-4118
Phone
(337) 474-6370
NPI assigned
May 7, 2025
Last updated
May 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 240295 LA Primary

Addresses

Primary practice location

4200 Nelson Rd
Lake Charles, LA 70605-4118

Mailing address

4200 Nelson Rd
Lake Charles, LA 70605-4118
Phone (337) 474-6370

Other practice location 1

524 Dr Michael Debakey Dr
Lake Charles, LA 70601-5725
Phone (337) 436-2511

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
I20250812004405 LA Practitioner - Nurse Practitioner 3678071255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calcasieu Emergency Group LLCGroup PAC ID 4183651425, 25 clinicians

Practice addresses (Care Compare)

524 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5725
Phone (337) 436-2511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Emergency Group LLC Nurse Practitioner CurrentSince Jul 1, 2025 Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

4200 Nelson Rd
Lake Charles, LA 70605
Phone (318) 474-6370

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

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.

Hospital & facility affiliations 6

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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1730979584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 NELSON RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054118",
            "telephone_number": "337-474-6370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 NELSON RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054118",
            "telephone_number": "337-474-6370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "524 Dr Michael Debakey Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706015725",
            "country_code": "US",
            "telephone_number": "337-436-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISNUKE",
        "first_name": "ANISSA",
        "middle_name": "M",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "240295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.