DR. JOHN KALIEB POURCIAU (NPI# 1053589580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053589580 |
| Entity Type | Individual |
| Full Name | DR. JOHN KALIEB POURCIAU |
| Credential | D.P.M. |
| Practice Address |
1747 Imperial Blvd Lake Charles LA 70605-5362 |
| Mailing Address |
501 Dr Michael Debakey Dr Lake Charles LA 70601-5724 |
| Practice Telephone | 3377217236 |
| Practice Fax Number | 3377217237 |
| Mailing Telephone | 3374338400 |
| Mailing Fax Number | 3373126708 |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2017-01-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
DPM200016 | LA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1198501 | 05 |
| Street Address |
1747 IMPERIAL BLVD |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70605-5362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487649091 | Staci Simon Boudreaux | Physician Assistant | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2005-09-20 |
| 1376168971 | Cody Gaupel | Student in an Organized Health Care Education/Training Program | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2020-06-10 |
| 1538703335 | Center for Orthopaedics and Spine LLC | Family Medicine | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-11-05 |
| 1013579150 | Bradley Lane Jimerson | Student in an Organized Health Care Education/Training Program | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-06-28 |
| 1912560541 | Haley Cook Cart | Physician Assistant | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2019-04-18 |
| 1174014534 | Susan Helms Cart | Occupational Therapist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2018-05-22 |
| 1679071161 | Ashley A Nix | Registered Nurse | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2018-01-30 |
| 1235584004 | Matthew Mccabe | Podiatrist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2016-04-29 |
| 1295100808 | Lauren Ashley Sexton | Specialist/Technologist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2015-12-08 |
| 1326422924 | Lance Henagan | Nurse Practitioner | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2015-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283606 | Kristin R Morris | Clinical Nurse Specialist | 1900 W. Gaythier Rd, Lake Charles, LA 70605 | 2020-10-21 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1053898403 | Heather Spallino Duplechain | Nurse Practitioner | 6713 Nelson Rd., Lake Charles, LA 70605 | 2018-07-27 |
| 1578057956 | Noor Deeb Weckerly | Nurse Practitioner | 6713 Nelson Rd, Lake Charles, LA 70605 | 2018-06-19 |
| 1861993354 | Therapy Works of Swla LLC | Physical Therapist | 4750 Lake Street, Lake Charles, LA 70605 | 2018-02-21 |
| 1669998852 | Amd Healthcare Lc, LLC | General Acute Care Hospital | 3730 Nelson Road, Lake Charles, LA 70605 | 2017-08-18 |
| 1619422474 | Kaitlyn Pinkerton | Specialist/Technologist | 800 E Mcneese St, Lake Charles, LA 70605 | 2016-08-22 |
| 1104274679 | Kelly Rogers | Counselor | 90 N. Luke 102l, Lafayette, LA 70605 | 2016-05-25 |
| 1548616220 | Lisa Monticello Snider | Neurological Surgery | 3297 Portrush Drive, Lake Charles, LA 70605 | 2016-05-11 |
| 1114387404 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 4459 Nelson Rd, Suite 120, Lake Charles, LA 70605 | 2016-02-29 |
| Find all providers in zip 70605 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588835557 | Garber Foot & Ankle Clinic | Podiatrist | 651 S Ryan St, Lake Charles, LA 70601-5726 | 2008-03-18 |
| 1043218449 | Vernon L Garber | Podiatrist | 651 Dr Michael Debakey Dr, Lake Charles, LA 70601-5726 | 2005-07-09 |
| 1376964627 | Louisiana Foot and Ankle Specialists LLC | Podiatrist | 212 W Mcneese St, Lake Charles, LA 70605-5639 | 2014-01-03 |
| 1891124665 | Daniel Thomas Hall Iv | Podiatrist | 212 W Mcneese St, Lake Charles, LA 70605-5639 | 2013-11-02 |
| 1437449915 | Mallory Michelle Przybylski | Podiatrist | 212 W Mcneese St, Lake Charles, LA 70605-5639 | 2011-04-18 |
| 1407001787 | Tyson Ellis Green | Podiatrist | 1747 Imperial Blvd, Lake Charles, LA 70605-5362 | 2008-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043836166 | Thibodaux Regional Network Development Corporation | Podiatrist | 726 N Acadia Rd Ste 1700, Thibodaux, LA 70301-5051 | 2020-06-24 |
| 1437780939 | Louisiana Foot and Ankle Surgeons, LLC | Podiatrist | 401 Veterans Blvd Ste 207, Metairie, LA 70005-2957 | 2020-02-03 |
| 1326682089 | Center for Orthopaedics and Spine LLC | Podiatrist | 250 Beglis Pkwy Ste 1, Sulphur, LA 70663-3503 | 2019-11-05 |
| 1275063703 | Dr Rene J Hymel Dpm LLC | Podiatrist | 2101 Robin Ave Ste 11, Hammond, LA 70403-5773 | 2017-06-18 |
| 1205369840 | Christian Antonio Valle | Podiatrist | 3601 Desiard St, Monroe, LA 71203-4352 | 2017-04-11 |
| 1134576754 | Gabrielle Sharon Clark | Podiatrist | 10555 Lake Forest Blvd Ste 3a-b, New Orleans, LA 70127-5206 | 2016-05-24 |
| 1497141311 | Pelican State Foot & Ankle Care LLC | Podiatrist | 1938 Jackson St, Alexandria, LA 71301-6437 | 2015-04-07 |
| 1013328996 | The Foot and Ankle Clinic of West Monroe, LLC | Podiatrist | 2269 Arkansas Road, West Monroe, LA 71291 | 2014-05-14 |
| 1457773863 | Edugie Valentine Omoregbee | Podiatrist | 203 W Brentwood Blvd Ste 2, Lafayette, LA 70506-6190 | 2014-01-20 |
| 1245503119 | Gentry Haughton LLC | Podiatrist | 600 Unadilla St, Shreveport, LA 71106-1242 | 2012-02-22 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70605 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.