Active NPI
Mary Walters
- Early Intervention Provider Agency
- Lake Charles, LA
National Provider Identifier
1831717016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- Practice address
- 5876 Mark Lebleu Rd
Lake Charles, LA 70615-4501 - Phone
- (337) 794-4207
- NPI assigned
- Jul 14, 2020
- Last updated
- Jul 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Primary |
Addresses
Primary practice location
5876 Mark Lebleu Rd
Lake Charles, LA 70615-4501
Mailing address
5876 Mark Lebleu Rd
Lake Charles, LA 70615-4501
Phone (337) 794-4207
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594684800000",
"number": "1831717016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5876 MARK LEBLEU RD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706154501",
"telephone_number": "337-794-4207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5876 MARK LEBLEU RD",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706154501",
"telephone_number": "337-794-4207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-14",
"last_updated": "2020-07-14",
"certification_date": "2020-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": null,
"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 Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.