Pediatric Cardiology of Southwest Louisiana, LLC

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

MD.203075 Issued in LA

Legal business name

PEDIATRIC CARDIOLOGY OF SOUTHWEST LOUISIANA, LLC

Practice address

2005 Southwood Dr
Lake Charles, LA 70605-4139

Phone

(337) 562-2293

Fax

(337) 562-1469

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Mudar M Kattash, M.D.NPI 1174508741

Title

Owner

Phone

(337) 562-2293

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 3

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

• Mudar Kattash, MD

  • Pediatric Cardiology Physician
  • Lake Charles, LA
  • NPI 1174508741
  Medicare reassignment Care Compare group NPD Authorized official
• Megan Leblanc Thibodeaux, NP

  • Family Nurse Practitioner
  • Lake Charles, LA
  • NPI 1043783814
  Medicare reassignment Care Compare group NPD
• Nazire Ozcelik, M.D.

  • Pediatric Cardiology Physician
  • Corpus Christi, TX
  • NPI 1366699159

  LA

  Medicare reassignment NPD

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1962559740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 SOUTHWOOD DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054139",
            "telephone_number": "337-562-2293",
            "fax_number": "337-562-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 SOUTHWOOD DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054139",
            "telephone_number": "337-562-2293",
            "fax_number": "337-562-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY OF SOUTHWEST LOUISIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "KATTASH",
        "authorized_official_first_name": "MUDAR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-562-2293",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "LA",
            "license": "MD.12869R",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "LA",
            "license": "MD.203075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Expression Chiropractic LLC
• Larisa Liles Pearce, LDN RD
• Todd Allen Peavy, MD
• Shreyas Venkat Peddigari, MD
• Alana Christine Peden, LPN
• Pediatric Therapy of Louisiana
• Pediatrust Lake Charles, LLC
• Colton Don Peebles, B.C.B.A., L.B.A.
• Levince Oliver Peeples, LPN
• Claire Theresa Pellerin, L.P.C., L.M.F.T.

• Pediatric Cardiology Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Pediatric Cardiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.