Clark Warden, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

017994 Issued in LA

Practice address

7015 Hwy 190 E Serv Rd
Suite 200
Covington, LA 70433-4960

Phone

(985) 234-3000

Fax

(985) 234-3002

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Tulane University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of the Lake Surgical Hospital Hospital, Slidell, LA, CCN 190270
• Our Lady of the Angels Hospital Hospital, Bogalusa, LA, CCN 190312

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Surgery

  Medicare reassignment Care Compare group NPD
• Our Lady of the Angels Hospital, Inc.

  • General Acute Care Hospital
  • Bogalusa, LA
  • NPI 1912334533
  Medicare reassignment
• Our Lady of the Lake Physician Group LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group, LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1588062079
  NPD
• Wash-St Tammany Reg Medical Center

  • General Acute Care Hospital
  • Bogalusa, LA
  • NPI 1508809088
  NPD
• Our Lady of the Angels Hospital, Inc.

  • General Acute Care Hospital
  • Bogalusa, LA
  • NPI 1093140600
  NPD (past)
• Our Lady of the Lake Physician Group LLC

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455

  Surgery

  NPD (past)
• Washington St. Tammany Regional Medical Center

  • Pharmacy
  • Bogalusa, LA
  • NPI 1801801436
  NPD (past)

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

• Lake Surgical Hospital Slidell, LLC

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1821465576
  Care Compare affiliation
• Our Lady of the Angels Hospital, Inc.

  • General Acute Care Hospital
  • Bogalusa, LA
  • NPI 1093140600
  Care Compare affiliation

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1831159631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "985-234-3000",
            "fax_number": "225-526-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 HWY 190 E SERV RD",
            "address_2": "SUITE 200",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334960",
            "telephone_number": "985-234-3000",
            "fax_number": "985-234-3002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Avenue F",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273634",
            "country_code": "US",
            "telephone_number": "985-730-6711",
            "fax_number": "985-882-5997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARDEN",
        "first_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "017994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1197131",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua K Walls, MD
• Michael E Walsh, MD
• Geneal Poynter Walters, CCC-SLP
• Tamu A Walters, CAC
• Teresita M. Walters, BCBA, LBA
• Matthew J Warren
• Tamara Shenee Washington
• Delia Waskom, FNP
• Victoria H Waterfield, LCSW
• Donald James Waterman Jr., PH.D.

• Surgery Physician in Covington, LA
• Providers in Covington, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.