EXECUTIVE MEDICAL CLINIC OF LAKE CHARLES
NPI 1982126520
Family Medicine in Lake Charles, LA
NPI Status: Active since July 14, 2017
Contact Information
765 EAST BAYOU PINES DRIVE
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 210-1260
- Organization
- Family Medicine
- CLIA Number: 19D2133514
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-13-2027
About EXECUTIVE MEDICAL CLINIC OF LAKE CHARLES
This page provides the complete NPI Profile along with additional information for Executive Medical Clinic Of Lake Charles, a primary care provider established in Lake Charles, Louisiana operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1982126520 assigned on July 2017. The practitioner's primary taxonomy code is 207Q00000X with license number AP06496 (LA). The provider is registered as an organization and their NPI record was last updated 4 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Melissa Lebrun Dnp (President)
- NPI
- 1982126520
- Provider Name
- EXECUTIVE MEDICAL CLINIC OF LAKE CHARLES
- Entity Type
- Organization
- Location Address
- 765 EAST BAYOU PINES DRIVE LAKE CHARLES, LA 70601
- Location Phone
- (337) 210-1260
- Mailing Address
- 765 EAST BAYOU PINES DRIVE LAKE CHARLES, LA 70601
- Mailing Phone
- (337) 210-1260
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-14-2017
- Last Update Date
- 09-19-2022
- Code Navigator
A primary care provider (PCP) like Executive Medical Clinic Of Lake Charles sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- AP06496
- License State
- LA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 19D2133514
- Facility Type
- Physician Office
- Certificate Effective Date
- July 14, 2025
- Certificate Expiration Date
- July 13, 2027
- Laboratory Director
- JESSICA SONNIER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Executive Medical Clinic Of Lake Charles to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1982126520, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 60 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982126520, enumerated as an "organization" on July 14, 2017.
The provider is located at 765 EAST BAYOU PINES DRIVE LAKE CHARLES, LA 70601 and the phone number is (337) 210-1260.
Family Medicine with taxonomy code 207Q00000X.
