NPIMap

Organization Active NPI

Marillac Community Health Centers

Doing business as DePaul Community Health Centers- Homer Plessy Treme Campus

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
National Provider Identifier
1013522879
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARILLAC COMMUNITY HEALTH CENTERS
Doing business as
DePaul Community Health Centers- Homer Plessy Treme Campus
Practice address
1423 Saint Philip St
New Orleans, LA 70116-2933
Phone
(504) 207-3064
Fax
(504) 282-2213
NPI assigned
Sep 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Michael Griffin
Title
Ceo
Phone
(504) 212-9538

Specialties & licenses 1

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

Addresses

Primary practice location

1423 Saint Philip St
New Orleans, LA 70116-2933

Mailing address

PO Box 13038
New Orleans, LA 70185-3038
Phone (504) 207-3060

Other names 1

  • DePaul Community Health Centers- Homer Plessy Treme Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210128000503 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678755535 Practice locations: New Orleans, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013522879. Details of each certification follow.

Federally qualified health center certification: CCN 191056

Legal name
MARILLAC COMMUNITY HEALTH CENTERS
Doing business as
DEPAUL COMMUNITY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 27, 2021
Last certification
Jan 27, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 15, 2010 in LA
Enrollment address
1423 Saint Philip St
New Orleans, LA 70116-2933

National Provider Directory

National Provider Directory
Tax ID family
Marillac Comm HLTH Centers70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

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

View all 13

Locations

5800 Saint Roch Ave
New Orleans, LA 70122
Phone (504) 547-5062

1025 Napoleon Ave
New Orleans, LA 70115
Phone (504) 891-1927

5300 Berkley Dr
New Orleans, LA 70131
Phone (504) 302-7121

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Ellen Kron Individual OtherBoard Member Jan 1, 2019
Wendy Rios-Wood Individual W-2 Managing EmployeeDelegated Official Jan 1, 2023
Michael Deyoung Individual OtherBoard Member Jan 1, 2019
Roderic Teamer Individual OtherBoard Member Jan 1, 2019
Ronald Carrere Individual OtherBoard Member Jan 1, 2019
Sarah Moody-Thomas Individual OtherBoard Member Jan 1, 2019
Flori Hicks Individual OtherBoard Member Jan 1, 2019
Stephanie Navarre Individual OtherBoard Member Jan 1, 2019
Marjorie Hebert Individual OtherBoard Member Jan 1, 2019
Catherine Kelly Individual OtherBoard Member Jan 1, 2019
Anna Garner Individual OtherBoard Member Jan 1, 2019
Michael Griffin Individual Corporate DirectorPresident/Ceo Apr 1, 2008
W-2 Managing EmployeePresident/Ceo Apr 1, 2008
Robert Angelico Individual OtherBoard Member Jan 1, 2019
Jedidah Jackson Individual OtherBoard Member Jan 1, 2019

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Depaul Community Health CentersNew Orleans, LA, CCN 191974 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 15, 2010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1013522879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13038",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701853038",
            "telephone_number": "504-207-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 SAINT PHILIP ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701162933",
            "telephone_number": "504-207-3064",
            "fax_number": "504-282-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILLAC COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2022-11-22",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-212-9538"
    },
    "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": "DePaul Community Health Centers- Homer Plessy Treme Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DePaul Community Health Centers- Homer Plessy Treme Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.