Coastal Pain Care Lake Charles, LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

016824 Issued in LA

Legal business name

COASTAL PAIN CARE LAKE CHARLES, LLC

Practice address

215 W Prien Lake Rd
Lake Charles, LA 70601-8450

Phone

(337) 477-9019

Fax

(337) 478-1290

NPI assigned

May 28, 2006

Last updated

Apr 25, 2013By 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

Miss Kristi Widcamp

Title

Manager

Phone

(337) 477-9019

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joshua A Allen, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Beaumont, TX
  • NPI 1699760264
  NPD (past)
• Daniel Lee Harris, MD

  • Pain Medicine (Anesthesiology) Physician
  • Beaumont, TX
  • NPI 1942332242
  NPD (past)

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366848000000",
    "number": "1881641405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4840",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706064840",
            "telephone_number": "337-477-9019",
            "fax_number": "337-478-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W PRIEN LAKE RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018450",
            "telephone_number": "337-477-9019",
            "fax_number": "337-478-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PAIN CARE LAKE CHARLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2013-04-25",
        "status": "A",
        "authorized_official_last_name": "WIDCAMP",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "337-477-9019",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "LA",
            "license": "016824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Tania Clemons, APRN, FNP-C
• Sarah E Clevenger, M.D.
• Clinic808 LLC
• Kashia Clopper
• Emily Clyde, MS, RDN, LDN
• Coastal Surgery Center, LLC
• Amber Coates
• Kelsey Cobb, FNP
• Jacob Gus Cochran
• Robert Charles Cochran, DDS

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; 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.