Mmg Nelson Rd LLC
NPI 1295103844ActiveOrganization· General Practice· Lake Charles, LA
General Practice in Lake Charles, Louisiana, registered in NPPES in September 2015, part of Memorial Medical Group. The authorized official on file is Dawn Johnson-Hatcher, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1295103844 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Memorial Medical Group |
| NPI issued | Sep 11, 2015 |
| Last updated in NPPES | Dec 4, 2023 |
| Certified by provider | Dec 4, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Psychiatry & Neurology, Neurology | 2084N0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (LA) |
|---|
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