Active NPI
W O Moss Regional Medical Center
- Certified Registered Nurse Anesthetist
- Lake Charles, LA
National Provider Identifier
1770524597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Legal business name
- W O MOSS REGIONAL MEDICAL CENTER
- Practice address
- 1000 Walters St
Lake Charles, LA 70607-4647 - Phone
- (337) 475-8100
- Fax
- (337) 475-8104
- NPI assigned
- Jun 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donald R Smithburg
- Title
- Vice Chancellor Ceo
- Phone
- (225) 922-1474
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | |||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Certified Registered Nurse Anesthetist | 367500000X | Primary |
Addresses
Primary practice location
1000 Walters St
Lake Charles, LA 70607-4647
Mailing address
1000 Walters St
Lake Charles, LA 70607-4647
Phone (337) 475-8100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1799165 | Medicaid | LA | |
| 1449415 | Medicaid | LA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149897600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1770524597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 WALTERS ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706074647",
"telephone_number": "337-475-8100",
"fax_number": "337-475-8104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 WALTERS ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706074647",
"telephone_number": "337-475-8100",
"fax_number": "337-475-8104"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "W O MOSS REGIONAL MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-10",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "SMITHBURG",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "VICE CHANCELLOR CEO",
"authorized_official_telephone_number": "225-922-1474",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Anesthetist, Certified Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1799165",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1449415",
"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 Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.