NPIMap

Organization Active NPI

Children's Hospital

  • Children's Hospital
  • New Orleans, LA
National Provider Identifier
1104819366
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
256 Issued in LA
Legal business name
CHILDREN'S HOSPITAL
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone
(504) 896-9511
Fax
(504) 896-9700
NPI assigned
Aug 23, 2005
Last updated
Oct 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Authorized official

Name
Lucio Fragouso
Title
Cfo
Phone
(504) 896-9461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 256 LA Primary

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5720

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 896-9511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090731000249 LA Part A Provider - Hospital 3971401944 Practice locations: Metairie, LA; Slidell, LA; New Orleans, LA; Covington, LA; Destrehan, LA; Laplace, LA; Marrero, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104819366. Details of each certification follow.

Hospital certification: CCN 193300

Legal name
CHILDREN'S HOSPITAL
Doing business as
MANNING FAMILY CHILDREN'S
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jan 1, 1984
Last certification
Oct 26, 2024
Beds
227
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
200 Henry Clay Ave
New Orleans, LA 70118-5720
Main/Primary Hospital Location
Hospital subgroups
Children’s

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Childrens HospitalCCN 193300 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Children's Hospital10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

5024 Keystone Blvd
Covington, LA 70433

2121 Ridgelake Dr
#1
Metairie, LA 70001

Ownership & related parties

All disclosed owners & managing parties 33

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

NameRoleSinceShare
A W Hugley Individual Corporate Director Apr 30, 2009
Tod Smith Individual Corporate Director May 23, 2019
Ralph Brennan Individual Corporate Director Apr 30, 2009
Elwood Cahill Individual Corporate Director Apr 30, 2009
Elizabeth Lauricella Individual Corporate Director Apr 30, 2009
Louisiana Children's Medical Center Organization, New Orleans, LA 5% Or Greater Direct Ownership Interest Jul 13, 2009
Operational/Managerial Control Jul 13, 2009
Walton Goldring Individual Corporate Director Mar 29, 2018
Philip Claverie Individual Corporate Director Apr 30, 2009
Andrea Chen Individual Corporate Director Jul 22, 2021
Katie Crosby Individual Corporate Director Mar 27, 2008
Anthony Recasner Individual Corporate Director Apr 30, 2009
Matthew Garrett Timmons Individual W-2 Managing Employee Jun 1, 2023
Marilee Kennan Hovet Individual Corporate Director Apr 27, 2023
John R Nickens Individual W-2 Managing Employee Nov 1, 2017
Lucio Fragoso Individual Corporate OfficerCeo Jan 21, 2021
W-2 Managing EmployeeCeo Jan 21, 2021
William H Langenstein Individual Corporate Director Apr 27, 2023
Jessica Brandt Individual Corporate Director Sep 24, 2020
John Pearce Individual Corporate Director Apr 30, 2009
Children's Hospital Organization, New Orleans, LA Operational/Managerial Control Jan 1, 2004
Gregory St. Etienne Individual Corporate Director Mar 25, 2021
Elizabeth Sullivan Individual Corporate Director Apr 30, 2009
Jessica Cahill Individual Corporate OfficerCfo Jan 1, 2023
W-2 Managing Employee Jan 1, 2023
William L Mimeles Individual Corporate Director Apr 30, 2009
Gregory C Feirn Individual W-2 Managing Employee May 1, 2014
Susan Johnson Individual Corporate Director Apr 30, 2009
Julie L George Individual Corporate Director Apr 30, 2009
Henry Matthew Peltier Individual Corporate Director Mar 29, 2018
Mark W Kline Individual W-2 Managing Employee May 27, 2021
Pinki K Prasad Individual Corporate Director Mar 25, 2021
Stephen Hales Individual Corporate Director Apr 30, 2009
Kaylea Hill Individual Corporate Director May 23, 2019
Louis Lauricella Individual Corporate Director May 27, 2017
Kenneth Beer Individual Corporate Director Apr 30, 2009

Owners & managing parties with NPI records 5

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 82

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 82

Affiliated clinicians 57

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1104819366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-9511",
            "fax_number": "504-896-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-9511",
            "fax_number": "504-896-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "FRAGOUSO",
        "authorized_official_first_name": "LUCIO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "504-896-9461"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "LA",
            "license": "256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.