Kenneth Joseph Waddell

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

234093 Issued in LA

Practice address

1701 Oak Park Blvd
Lake Charles, LA 70601-8911

Phone

(337) 494-3000

NPI assigned

Feb 12, 2024

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

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

LCMS Cardiovascular Diseases, LLCGroup PAC ID 1951541515, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060

Medicare enrollment (NPD)

Enrolled

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.

• LCMS Cardiovascular Diseases, LLC

  dba MMG Anesthesia

  • Anesthesiology Physician
  • Lake Charles, LA
  • NPI 1285869370
  Medicare reassignment Care Compare group NPD

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

• Southwest Louisiana Hospital Association Inc

  dba Digestive Health Center of SWLA

  • Gastroenterology Physician
  • Lake Charles, LA
  • NPI 1285351411

  Hospital

  Care Compare affiliation
• Southwest Louisiana Hospital Association Inc

  dba Rheumatology Associates

  • Rheumatology Physician
  • Lake Charles, LA
  • NPI 1659424075

  Hospital

  Care Compare affiliation
• Southwest Louisiana Hospital Association Inc

  dba Lake Charles Memorial Hospital

  • General Acute Care Hospital
  • Lake Charles, LA
  • NPI 1972549855
  Care Compare affiliation

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708732800000",
    "number": "1912761768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 PINEWOOD DR S",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706077522",
            "telephone_number": "337-764-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018911",
            "telephone_number": "337-494-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADDELL",
        "first_name": "KENNETH",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "234093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanchi Ronnie Vu, MD
• W O Moss Regional Medical Center
• W O Moss Regional Medical Center
• W O Moss Regional Medical Center
• W.O. Moss Regional Medical Center
• Ka'Dea Wade-George, FNP
• Eric Waetjen, MD
• C. Eliska Wagnon
• Jennifer Ashley Wainwright, APRN, FNP-C
• Wal-Mart Stores East , LP (Walmart Pharmacy 10-0469)

• Certified Registered Nurse Anesthetist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Certified Registered Nurse Anesthetist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.