NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as Kenner CHC

  • Federally Qualified Health Center (FQHC)
  • Kenner, LA
National Provider Identifier
1104579630
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ACCESS HEALTH LOUISIANA
Doing business as
Kenner CHC
Practice address
819 W Esplanade Ave Ste B
Kenner, LA 70065-6291
Phone
(504) 575-3712
Fax
(504) 575-3691
NPI assigned
Feb 3, 2022
Last updated
Feb 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Mark F Keiser
Title
Ceo
Phone
(504) 575-3712

Specialties & licenses 1

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

Addresses

Primary practice location

819 W Esplanade Ave Ste B
Kenner, LA 70065-6291

Mailing address

2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712

Other names 1

  • Kenner CHC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220328001612 LA Part B Supplier - Clinic/Group Practice 3678484276 Receives reassigned benefits from 2 practitioners
Practice locations: Kenner, LA
O20220502000747 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Kenner, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104579630. Details of each certification follow.

Federally qualified health center certification: CCN 191096

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
KENNER COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 4, 2022
Last certification
Apr 4, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 1, 2003 in LA
Enrollment address
819 W Esplanade Ave
Ste B
Kenner, LA 70065-6291

National Provider Directory

National Provider Directory
Tax ID family
St Charles Community Health Center Inc89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

Locations

819 W Esplanade Ave
Ste B
Kenner, LA 70065
Phone (504) 475-9990

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Peter Torsch Individual Corporate Officer Mar 25, 2016
Corporate Director Mar 25, 2016
Germaine L Robottom Individual Corporate Officer Apr 23, 2015
Estelle Alfortish Individual Corporate Officer Feb 23, 2017
Gaynell Alexander-Coleman Individual Corporate Officer Jan 1, 2006
Brooks Trotter Individual Corporate Officer Mar 1, 2003
Scott Falgoust Individual Corporate Officer May 31, 2018
Access Health Louisiana Organization, Kenner, LA Non-profit Operational/Managerial Control Apr 1, 2003
Mark Francis Keiser Individual Corporate Officer Apr 1, 2003
Corporate Director Apr 1, 2003
W-2 Managing Employee Apr 1, 2003
Sandra Zimmer Individual Corporate Officer Oct 25, 2018
Francesca Vial Individual Corporate Officer Apr 1, 2003
John Cressend Schonberg Individual Corporate Officer Apr 1, 2003
Timothy J. Vial Individual Corporate Officer Apr 1, 2003

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
St James Alternative School SBHCVacherie, LA, CCN 191087 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Luling Elementary School SBHCLuling, LA, CCN 191100 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Destrehan HS SBHCDestrehan, LA, CCN 191104 Federally qualified health center Operational/Managerial Control Apr 1, 2003

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1643846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1104579630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654605",
            "telephone_number": "504-575-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 W ESPLANADE AVE STE B",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700656291",
            "telephone_number": "504-575-3712",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-575-3712"
    },
    "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": "Kenner CHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenner, LA

Sources for this page

Verify at the official NPI Registry.