NPIMap

Organization Active NPI

Southeast Community Health Systems

Doing business as Southeast Community Health Systems @ Greensburg

  • Federally Qualified Health Center (FQHC)
  • Greensburg, LA
National Provider Identifier
1023147113
Registry record updated Mar 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHEAST COMMUNITY HEALTH SYSTEMS
Doing business as
Southeast Community Health Systems @ Greensburg
Practice address
490 Sitman Street
Greensburg, LA 70441
Phone
(225) 222-6059
Fax
(225) 222-6543
NPI assigned
Mar 5, 2007
Last updated
Mar 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2015

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

Authorized official

Name
Dr. Alecia Cyprian
Title
Ceo
Phone
(225) 306-2010

Specialties & licenses 1

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

Addresses

Primary practice location

490 Sitman Street
Greensburg, LA 70441

Mailing address

Post Office Box 770
Zachary, LA 70791
Phone (225) 222-6059

Other identifiers 1

IdentifierTypeStateIssuer
1943207MedicaidLA

Other names 1

  • Southeast Community Health Systems @ Greensburg Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050124000119 LA Part B Supplier - Clinic/Group Practice 4284610437 Receives reassigned benefits from 36 practitioners
4 other NPIs on this enrollment
Practice locations: Greensburg, LA; Zachary, LA; Independence, LA; Kentwood, LA
O20091014000557 LA Part A Provider - Federally Qualified Health Center (FQHC) 4284610437 Practice locations: Greensburg, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023147113. Details of each certification follow.

Federally qualified health center certification: CCN 191820

Legal name
SOUTHEAST COMMUNITY HEALTH SYSTEMS
Doing business as
ST HELENA COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 29, 1994
Last certification
Mar 29, 1994
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 28, 1992 in LA
Enrollment address
490 Sitman St
Greensburg, LA 70441

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Albany Dental Clinic37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

336 E Railroad Ave
Independence, LA 70443
Phone (225) 306-2013

3057 Gentilly Blvd
New Orleans, LA 70122
Phone (504) 208-1427

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Terry Addison Individual Corporate OfficerBoard Member Jul 26, 2016
Mira L Robertson Individual Corporate Officer Feb 7, 2023
Theresa Bankston Individual W-2 Managing EmployeeCfo Feb 9, 2015
Rochell Bates Individual Operational/Managerial ControlBoard Member Apr 20, 2026
Major Coleman Individual Corporate Officer Sep 1, 2009
Margaret Smith Individual Operational/Managerial ControlBoard Member Apr 20, 2026
Michael Martin Individual Corporate OfficerBoard Member Jan 1, 2012
Alecia Cyprian Individual Corporate DirectorCeo Nov 1, 2014
W-2 Managing Employee Nov 1, 2014
Virginia Reeves Foster Individual W-2 Managing EmployeeCredentialing Specialist Mar 3, 2022
Paula McNabb Individual Corporate OfficerBoard Member Jan 1, 2012
Reyna E Lopez Individual Operational/Managerial ControlBoard Member Jan 1, 2020
Sandy K Tillery Individual Corporate Officer Jan 1, 2023
Dameon Jackson Individual Corporate OfficerBoard Chair Jan 1, 2007

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
KentwoodKentwood, LA, CCN 191841 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2008
AlbanyHammond, LA, CCN 191895 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2013
IndependenceIndependence, LA, CCN 191918 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2008
WMGHammond, LA, CCN 191965 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2008

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425600000000",
    "number": "1023147113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 770",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "70791",
            "telephone_number": "225-222-6059",
            "fax_number": "888-334-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 SITMAN STREET",
            "city": "GREENSBURG",
            "state": "LA",
            "postal_code": "70441",
            "telephone_number": "225-222-6059",
            "fax_number": "225-222-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST COMMUNITY HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-03-06",
        "status": "A",
        "authorized_official_last_name": "CYPRIAN",
        "authorized_official_first_name": "ALECIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-306-2010",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1943207",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Community Health Systems @ Greensburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensburg, LA

Sources for this page

Verify at the official NPI Registry.