NPIMap

Organization Active NPI

Southwest Louisiana Hospital Association Inc

Doing business as Lake Charles Memorial Hospital

  • General Acute Care Hospital
  • Lake Charles, LA
National Provider Identifier
1972549855
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
112 Issued in LA
Legal business name
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Doing business as
Lake Charles Memorial Hospital
Practice address
1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone
(337) 494-3000
Fax
(337) 494-2947
NPI assigned
Jun 21, 2006
Last updated
Dec 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Authorized official

Name
Mrs. Dawn Johnson
Title
Chief Financial Offier
Phone
(337) 494-2094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 112 LA Primary

Addresses

Primary practice location

1701 Oak Park Blvd
Lake Charles, LA 70601-8911

Mailing address

1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Phone (337) 494-3000

Other identifiers 13

IdentifierTypeStateIssuer
1720461MedicaidLA
112OtherLADHH LICENSE
130043603MedicaidTX
375150400OtherLADEPT OF LABOR
XHSP41087MedicaidCA
0002OtherLACHAMPUS ACUTE
0073977OtherLAAETNA - ALL
10494OtherLABCBS MEDICAL STAFF
0020349MedicaidMS
1796794MedicaidLA
90060OtherLABCBS ACUTE
04774OtherLABCBS ER
190060OtherTXTX WORK COMP CARRIERS

Other names 1

  • Lake Charles Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080529000876 LA Part A Provider - Hospital 3274427695 2 other NPIs on this enrollment
Practice locations: Lake Charles, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972549855. Details of each certification follow.

Hospital certification: CCN 190060

Legal name
SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC
Doing business as
LAKE CHARLES MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 13, 2023
Beds
407
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1701 Oak Park Blvd
Lake Charles, LA 70601-8911
Other Hospital Practice Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Lake Charles Memorial HospitalCCN 190060 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
John W Digiglia16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1727 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 430-3282

1727 Imperial Blvd
Bldg 1A
Lake Charles, LA 70605
Phone (337) 480-4948

2800 2nd Ave
Ste C
Lake Charles, LA 70601
Phone (337) 474-2082

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joseph Miller Individual Corporate OfficerBoard Member Jan 1, 2015
Neil Aspinwall Individual Corporate Officer Jan 1, 2018
Mitchell Adrian Individual Corporate OfficerBoard Member Jan 1, 2015
Collin S Bowe Individual Corporate Officer Jan 1, 2026
Benjamin Martin Azevedo Individual Corporate Officer Jan 1, 2026
Clifford Armand Courville Individual Corporate Officer Jan 1, 2019
William R Condos Individual Corporate Officer Jan 1, 2017
Ulysses Thibodeaux Individual Corporate OfficerBoard Member Jan 1, 2015
Denise E Rau Individual Corporate OfficerBoard Member Jan 1, 2015
Steven Gillespie Individual Corporate DirectorDirector of Finance Feb 19, 2026
W-2 Managing EmployeeDirector of Finance Feb 19, 2026
Operational/Managerial ControlDirector of Finance Feb 19, 2026
James Devon Hyde Individual Corporate OfficerCeo Apr 12, 2021
Alyson Irene Jones Individual Corporate Officer Jan 1, 2026
Louis Todd Individual Corporate OfficerBoard Member Jan 1, 2015
Daniel T Hall Individual Corporate Officer Jan 1, 2021

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Lake Charles Memorial HospitalLake Charles, LA, CCN 19T060 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Lake Charles Memorial HospitalLake Charles, LA, CCN 19S060 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014
Home Health Agency of Lake Charles Memorial HospitalLake Charles, LA, CCN 197005 Home health agency 5% Or Greater Direct Ownership Interest (100%) Feb 7, 1973
Iowa Health CenterIowa, LA, CCN 193408 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2010

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 72

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.

View all 72

Affiliated clinicians 465

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 465

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1972549855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018911",
            "telephone_number": "337-494-3000",
            "fax_number": "337-494-2947"
        },
        {
            "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",
            "fax_number": "337-494-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFIER",
        "authorized_official_telephone_number": "337-494-2094",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720461",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHH LICENSE",
            "identifier": "112",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130043603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "375150400",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP41087",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS ACUTE",
            "identifier": "0002",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - ALL",
            "identifier": "0073977",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL STAFF",
            "identifier": "10494",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020349",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1796794",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ACUTE",
            "identifier": "90060",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ER",
            "identifier": "04774",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX WORK COMP CARRIERS",
            "identifier": "190060",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Charles Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Charles Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.