Individual provider Active NPI

Patti Lynn Bray Ward, DC

  • Chiropractor
  • Lake Charles, LA
National Provider Identifier
1952748394
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1674 Issued in LA
Practice address
4211 Lake Street
Suite 20
Lake Charles, LA 70605
Phone
(337) 990-5497
Fax
(337) 990-5570
NPI assigned
May 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1674 LA Primary

Addresses

Primary practice location

4211 Lake Street
Suite 20
Lake Charles, LA 70605

Mailing address

4211 Lake Street
Suite 20
Lake Charles, LA 70605
Phone (337) 990-5497

Other names 1

  • Patti Lynn Bray Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130826000660 LA Practitioner - Chiropractic 2860635729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3403 Patrick St
Lake Charles, LA 70605-1715
Phone (337) 990-5497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1674LAMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Full of Grace Therapy LLC CurrentSince Apr 21, 2024 Accepting new patients

Locations

4211 Lake St
Ste 20
Lake Charles, LA 70605
Phone (337) 270-2424

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1952748394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 LAKE STREET",
            "address_2": "SUITE 20",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-990-5497",
            "fax_number": "337-990-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 LAKE STREET",
            "address_2": "SUITE 20",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70605",
            "telephone_number": "337-990-5497",
            "fax_number": "337-990-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY WARD",
        "first_name": "PATTI",
        "middle_name": "LYNN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-24",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATTI",
            "last_name": "BRAY",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 16, 2019; 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.