NPIMap

Organization Active NPI

Oceans Rog LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1922424357
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
OCEANS ROG LLC
Practice address
302 W McNeese St
Lake Charles, LA 70605-5604
Phone
(337) 210-4477
NPI assigned
Mar 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stuart J Archer
Title
Ceo
Phone
(972) 464-0022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

302 W McNeese St
Lake Charles, LA 70605-5604

Mailing address

3905 Hedgcoxe Rd Unit 250249
Plano, TX 75025-0840
Phone (972) 464-0022

Other identifiers 3

IdentifierTypeStateIssuer
2396714MedicaidLA
357168OtherLAPTAN
357171OtherLAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140627001707 LA Part B Supplier - Clinic/Group Practice 1355566712 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
Practice locations: Lake Charles, LA; Opelousas, LA; Marrero, LA; Hammond, LA; Gretna, LA; Deridder, LA; Broussard, LA; Baton Rouge, LA…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

302 W McNeese St
Lake Charles, LA 70605
Phone (337) 210-1207

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1922424357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 HEDGCOXE RD UNIT 250249",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750250840",
            "telephone_number": "972-464-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055604",
            "telephone_number": "337-210-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCEANS ROG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "ARCHER",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-464-0022"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2396714",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "357168",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "357171",
            "state": "LA"
        }
    ],
    "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 Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.