NPIMap

Organization Active NPI

Primary Health Services Center

Doing business as PHSC West Monroe Family Health Center

  • Federally Qualified Health Center (FQHC)
  • West Monroe, LA
National Provider Identifier
1104384205
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY HEALTH SERVICES CENTER
Doing business as
PHSC West Monroe Family Health Center
Practice address
301 McMillan Rd
West Monroe, LA 71291-5323
Phone
(318) 737-7616
Fax
(318) 855-5158
NPI assigned
Mar 7, 2019
Last updated
Apr 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Authorized official

Name
Mrs. Catherine M Tonore
Title
Chief Executive Officer
Phone
(318) 388-1250

Specialties & licenses 1

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

Addresses

Primary practice location

301 McMillan Rd
West Monroe, LA 71291-5323

Mailing address

PO Box 7495
Monroe, LA 71211-7495
Phone (318) 388-1250

Other names 1

  • PHSC West Monroe Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051110000010 LA Part B Supplier - Clinic/Group Practice 2062300858 Receives reassigned benefits from 29 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grambling, LA; Monroe, LA; West Monroe, LA
O20190702000481 LA Part A Provider - Federally Qualified Health Center (FQHC) 2062300858 Practice locations: West Monroe, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104384205. Details of each certification follow.

Federally qualified health center certification: CCN 191013

Legal name
PRIMARY HEALTH SERVICES CENTER
Doing business as
PHSC WEST MONROE FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 28, 2019
Last certification
Jun 28, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 7, 1997 in LA
Enrollment address
301 McMillan Rd
West Monroe, LA 71291-5323

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Primary Health Services Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

2913 Betin Ave
Monroe, LA 71201
Phone (318) 651-0041

2945 Renwick St
Monroe, LA 71201
Phone (318) 654-8760

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Willie Robinson Individual 5% Or Greater Direct Ownership InterestBoard Member Dec 1, 2016
Primary Health Services Center Organization, West Monroe, LA 5% Or Greater Direct Ownership Interest Jun 28, 2019 100%
Cathy Holmes-Giles Individual 5% Or Greater Direct Ownership Interest Dec 1, 2016
Sallie M Evans Individual 5% Or Greater Direct Ownership InterestBoard Member Apr 1, 2019 5%
Betty Bullock Individual 5% Or Greater Direct Ownership InterestBoard Member Dec 1, 2016
Sandra Daigre Individual 5% Or Greater Direct Ownership InterestBoard Member Dec 1, 2016
Shelia Riley Individual 5% Or Greater Direct Ownership InterestBoard Member Apr 1, 2021 5%
Vanessa Johnson Individual 5% Or Greater Direct Ownership InterestBoard Member Dec 1, 2016
Leon Smith Individual 5% Or Greater Direct Ownership InterestBoard Member Dec 1, 2016
Bertha Williams Individual 5% Or Greater Direct Ownership InterestBoard Member Dec 1, 2016
Catherine M Tonore Individual 5% Or Greater Direct Ownership InterestAuthorizing Official Nov 1, 2012 0.05%
W-2 Managing EmployeeCeo Nov 1, 2012 0.05%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
We Care Health ClinicMonroe, LA, CCN 191838 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2002
Primary Health Services Center- Women Health and Pediatric ClinicMonroe, LA, CCN 191901 Federally qualified health center 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Nov 1, 2012
Nov 1, 2012
PHSC- Grambling Family Health CenterGrambling, LA, CCN 191969 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 19, 2017
Primary Health Services CenterMonroe, LA, CCN 191142 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 21, 2023

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1104384205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7495",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712117495",
            "telephone_number": "318-388-1250",
            "fax_number": "318-388-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MCMILLAN RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915323",
            "telephone_number": "318-737-7616",
            "fax_number": "318-855-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH SERVICES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-07",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A",
        "authorized_official_last_name": "TONORE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "318-388-1250",
        "authorized_official_name_prefix": "Mrs."
    },
    "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": "PHSC West Monroe Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHSC West Monroe Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.