W.O. Moss Regional Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

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) 415-8104

NPI assigned

Mar 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841328549",
    "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": "337-415-8104"
        },
        {
            "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": "337-415-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W.O. MOSS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "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": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449415",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anurag Reddy Vootla
• Vanchi Ronnie Vu, MD
• W O Moss Regional Medical Center
• W O Moss Regional Medical Center
• W O Moss Regional Medical Center
• Kenneth Joseph Waddell
• Ka'Dea Wade-George, FNP
• Eric Waetjen, MD
• C. Eliska Wagnon
• Jennifer Ashley Wainwright, APRN, FNP-C

• Primary Care Clinic/Center in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Primary Care Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.