Kenneth Lane Gary, N.P.
Individual provider Active NPI Family Nurse Practitioner · Sulphur, LA
NPI 1992849244 · NPPES record last updated Mar 9, 2015
Key facts
- NPI
- 1992849244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN094922-AP04928 (LA)
- Practice address
- 701 Cypress St
Sulphur, LA 70663-5053 - Phone
- (337) 527-4270
- Fax
- (337) 527-4288
- NPI assigned
- Feb 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Charles Urgent Care
Lcuc Family Physicians Urgent Care LLC
Imperial Health LLP
Practice addresses (Care Compare)
1905 Country Club Rd
Lake Charles, LA 70605-5203
Phone (337) 990-8000
2400 Ryan St
Lake Charles, LA 70601-7322
Phone (337) 433-1260
301 S Cities Service Hwy
Sulphur, LA 70663-6405
Phone (337) 888-3171
501 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 433-8400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080320000369 | LA | Practitioner - Nurse Practitioner | 0042396731 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN094922-AP04928 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imperial Health LLP | Current |
Accepting new patients | |
| Calcasieu Cameron Emergency Physician Group LLC | Current |
Accepting new patients | |
| Lcuc Family Physicians Urgent Care LLC | Current |
Accepting new patients | |
| Lake Charles Primary Care and Wellness | Current |
Accepting new patients | |
| Calcasieu Cameron Hospital Medicine Group LLC | Current |
Accepting new patients | |
| Professional Emergency Medicine Management -- Lake Charles LLC | Current |
Accepting new patients | |
| Imperial Health, LLP | Current |
Accepting new patients | |
| Lake Charles Urgent Care | Current |
Accepting new patients | |
| Cardiovascular Specialists of Southwest Louisiana, LLC | Past | Accepting new patients | |
| Lake Charles Memorial Heart and Vascular Center | Past |
Accepting new patients |
Locations
4201 Nelson Rd
Ste 100
Lake Charles, LA 70605
Phone (337) 310-2273
1905 Country Club Rd
Ste B
Lake Charles, LA 70605
Phone (337) 990-8002
1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000
501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258
277 N Highway 171
Ste 10
Lake Charles, LA 70611
Phone (337) 217-7762
1905 Country Club Rd
Lake Charles, LA 70605
Phone (337) 990-8000
701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270
301 S Cities Service Hwy
Sulphur, LA 70663
Phone (337) 527-6416
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN094922-AP04928 | LA | Yes |
Addresses
Primary practice location
701 Cypress St
Sulphur, LA 70663-5053
Mailing address
4521 Oak Ridge Dr
Sulphur, LA 70665-9379
Phone (337) 526-2777
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1019631 | Medicaid | LA |
Other providers in Sulphur, LA
- Steven Franks
- Freedom Pharmacy LLC
- Fresenius Medical Care Sulphur, LLC
- Jason Brian Fuqua
- Kelly Marie Fuqua
- Stephanie Ann Gary
- Genoa Healthcare LLC
- Tiffany Kathleen Gibbs
- Juanita Tarver Gilbert
- Dori Gilder
All providers in Sulphur, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.