NPIMap

Organization Active NPI

City of New Orleans

  • Public Health or Welfare Agency
  • New Orleans, LA
National Provider Identifier
1043427693
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CITY OF NEW ORLEANS
Practice address
2222 Simon Bolivar Ave
2ND Floor
New Orleans, LA 70113-1460
Phone
(504) 565-7283
Fax
(504) 565-8057
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Willie Mae Martin
Title
Director
Phone
(504) 565-7287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

2222 Simon Bolivar Ave
2ND Floor
New Orleans, LA 70113-1460

Mailing address

2222 Simon Bolivar Ave
2ND Floor
New Orleans, LA 70113-1460
Phone (504) 565-7283

Other identifiers 1

IdentifierTypeStateIssuer
1940810MedicaidLA

Other names 1

  • Health Care for the Homeless Program Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080430000573 LA Part A Provider - Federally Qualified Health Center (FQHC) 5092731505 Practice locations: New Orleans, LA
O20110919000202 LA Part B Supplier - Clinic/Group Practice 5092731505 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
Practice locations: New Orleans, LA
O20160411001213 LA DME Supplier - Physician - Family PracticeDME Supplier - Oral Surgery - Dentist 5092731505 Practice locations: New Orleans, LA

Federally qualified health center certification: CCN 191802

Legal name
CITY OF NEW ORLEANS
Doing business as
HEALTH CARE FOR THE HOMELESS
Organization structure
GovernmentNon-profit
Incorporated
Oct 1, 1991 in LA
Enrollment address
2222 Simon Bolivar Ave 2
New Orleans, LA 70113-1460

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
City of N O Dept of Hea17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

2222 Simon Bolivar Ave
#2
New Orleans, LA 70113
Phone (504) 658-2786

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
Jennifer L Avegno Individual Corporate DirectorDirector of Health Jul 20, 2018
Tevince Forest Individual W-2 Managing EmployeeAccountant Jan 31, 2017
City of New Orleans Organization, New Orleans, LA 5% Or Greater Direct Ownership Interest Oct 18, 1988 100%
Ragan P Collins Individual W-2 Managing EmployeeExecutive Director Mar 2, 2015 45%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Health Care for the Homeless Arthur Monday ClinicNew Orleans, LA, CCN 191032 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 21, 2019
City of New OrleansNew Orleans, LA, CCN 191093 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2021

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043427693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SIMON BOLIVAR AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701131460",
            "telephone_number": "504-565-7283",
            "fax_number": "504-565-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 SIMON BOLIVAR AVE",
            "address_2": "2ND FLOOR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701131460",
            "telephone_number": "504-565-7283",
            "fax_number": "504-565-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEW ORLEANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "504-565-7287",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1940810",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Care for the Homeless Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.