NPIMap

Organization Active NPI

Access Serenity of Louisiana, LLC

Doing business as Access Serenity

  • Psychiatry Physician
  • Many, LA
National Provider Identifier
1104378629
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ACCESS SERENITY OF LOUISIANA, LLC
Doing business as
Access Serenity
Practice address
187 S Tonti Dr
Many, LA 71449
Phone
(337) 802-1336
NPI assigned
Nov 1, 2016
Last updated
Jun 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Mr. Timothy Jason Reed
Title
Ceo
Phone
(337) 802-1336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

187 S Tonti Dr
Many, LA 71449

Mailing address

187 S Tonti Dr
Many, LA 71449
Phone (337) 802-1336

Other names 1

  • Access Serenity Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190410002760 LA Part B Supplier - Clinic/Group Practice 4385985803 Receives reassigned benefits from 12 practitioners
Practice locations: West Monroe, LA; Ville Platte, LA; Monroe, LA; Minden, LA; Leesville, LA; Ferriday, LA; Lake Charles, LA; Bastrop, LA…
O20200709000574 TX Part B Supplier - Clinic/Group Practice 4385985803 Receives reassigned benefits from 5 practitioners
Practice locations: Plainview, TX

National Provider Directory

National Provider Directory

Locations

1334 SW Buchanan St
#H
Topeka, KS 66604
Phone (785) 235-1294

414 Pine St
Monroe, LA 71201
Phone (318) 281-2448

128 Ridgedale Dr
West Monroe, LA 71291
Phone (318) 329-4279

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1104378629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 S TONTI DR",
            "city": "MANY",
            "state": "LA",
            "postal_code": "71449",
            "telephone_number": "337-802-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 S TONTI DR",
            "city": "MANY",
            "state": "LA",
            "postal_code": "71449",
            "telephone_number": "337-802-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS SERENITY OF LOUISIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-802-1336",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Serenity",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Access Serenity",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Many, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.