Lake Charles Ambulatory Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKE CHARLES AMBULATORY SURGERY CENTER, LP

Doing business as

Cardiovascular Outpatient Surgery Center of Southwest Louisiana

Practice address

401 Dr Michael Debakey Dr
Suite 310
Lake Charles, LA 70601-5864

Phone

(337) 602-9991

NPI assigned

May 5, 2016

Last updated

Jun 23, 2023By 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

Kelly Bemis

Title

Authorized Official

Phone

(858) 504-5667

Specialties & licenses 1

Addresses

Other names 1

• Cardiovascular Outpatient Surgery Center of Southwest Louisiana Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841646130. Details of each certification follow.

• CCN 19C0001135 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 19C0001135

Legal name

CARDIOVASCULAR OUTPATIENT SURGERY CENTER OF SOUTHW

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 15, 2017

Last certification

Dec 19, 2019

Ownership / control type

Proprietary

Facility address

401 Dr Michael Debakey Drive, Suite 310
Lake Charles, LA 70601

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

{
    "created_epoch": "1462406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1841646130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4417",
            "address_2": "DEPT #6026",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104417",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DR MICHAEL DEBAKEY DR",
            "address_2": "SUITE 310",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015864",
            "telephone_number": "337-602-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CHARLES AMBULATORY SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-05",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "BEMIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "858-504-5667"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular Outpatient Surgery Center of Southwest Louisiana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cardiovascular Outpatient Surgery Center of Southwest Louisiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lake Area TMS
• Lake Charles Addiction and Wellness Center (Addiction and Wellness)
• Lake Charles Anesthesiology, Apmc
• Lake Charles Clinical Trials, LLC
• Lake Charles Dialysis Center LLC
• Lake Charles Healthcare LLC (Landmark of Lake Charles)
• Lake Charles Hearing AIDS LLC (McMillin Hearing Aid Service)

• Ambulatory Surgical Clinic/Center in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Ambulatory Surgical Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.