Lakeside Medical Wellness Clinic
NPI 1407147234ActiveOrganization· Clinic/Center· Sulphur, LA
Clinic/Center in Sulphur, Louisiana, registered in NPPES in April 2011. The authorized official on file is Stacy W. Kirkum, Administrator.
Overview
| NPI | 1407147234 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 27, 2011 |
| Last updated in NPPES | Apr 27, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | MD14484R | LA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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