NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as Buckeye High SBHC

  • Federally Qualified Health Center (FQHC)
  • Deville, LA
National Provider Identifier
1003535121
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ACCESS HEALTH LOUISIANA
Doing business as
Buckeye High SBHC
Practice address
715 Highway 1207
Deville, LA 71328-8505
Phone
(866) 530-6111
NPI assigned
Aug 23, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Keiser
Title
Ceo
Phone
(504) 575-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

715 Highway 1207
Deville, LA 71328-8505

Mailing address

2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712

Other names 1

  • Buckeye High SBHC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230828002123 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Deville, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003535121. Details of each certification follow.

Federally qualified health center certification: CCN 191139

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
BUCKEYE HIGH SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2023
Last certification
Aug 3, 2023
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Mar 1, 2002 in LA
Enrollment address
715 Highway 1207
Deville, LA 71328-8505

National Provider Directory

National Provider Directory
Tax ID family
St Charles Community Health Center Inc89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

715 Highway 1207
Deville, LA 71328
Phone (318) 466-8335

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11331/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Peter Torsch Individual Corporate OfficerCfo Mar 1, 2002
Corporate DirectorCfo Mar 1, 2002
Mark Francis Keiser Individual Corporate OfficerCeo Mar 1, 2002
Corporate DirectorCeo Mar 1, 2002
W-2 Managing EmployeeCeo Mar 1, 2002
John Cressend Schonberg Individual Corporate OfficerVice Chairman of the Board Mar 1, 2002
Timothy J. Vial Individual Corporate OfficerChairman of the Board Mar 1, 2002

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St James Alternative School SBHCVacherie, LA, CCN 191087 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Kenner Community Health CenterKenner, LA, CCN 191096 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Luling Elementary School SBHCLuling, LA, CCN 191100 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Destrehan HS SBHCDestrehan, LA, CCN 191104 Federally qualified health center Operational/Managerial Control Apr 1, 2003

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1003535121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654605",
            "telephone_number": "504-575-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 HIGHWAY 1207",
            "city": "DEVILLE",
            "state": "LA",
            "postal_code": "713288505",
            "telephone_number": "866-530-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-575-3700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckeye High SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deville, LA

Sources for this page

Verify at the official NPI Registry.