NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as Destrehan High SBHC

  • Federally Qualified Health Center (FQHC)
  • Destrehan, LA
National Provider Identifier
1114684859
Registry record updated Nov 17, 2021
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
Destrehan High SBHC
Practice address
1 Wildcat LN
Destrehan, LA 70047-4001
Phone
(866) 530-6111
NPI assigned
Nov 17, 2021
Last updated
Nov 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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) 575-3700

Specialties & licenses 1

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

Addresses

Primary practice location

1 Wildcat LN
Destrehan, LA 70047-4001

Mailing address

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

Other names 1

  • Destrehan High SBHC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211027003027 LA Part B Supplier - Clinic/Group Practice 3678484276 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boutte, LA; Destrehan, LA; Luling, LA; Vacherie, LA
O20220630001033 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Destrehan, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114684859. Details of each certification follow.

Federally qualified health center certification: CCN 191104

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
DESTREHAN HS SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 30, 2022
Last certification
Jun 30, 2022
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 1, 2003 in LA
Enrollment address
1 Wildcat LN
Destrehan, LA 70047-4001

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Access Health Louisiana89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

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

View all 21

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 DirectorCfo Apr 1, 2017
Germaine L Robottom Individual Corporate Officer Nov 19, 2015
Estelle Alfortish Individual Corporate Officer Apr 23, 2018
Gaynell Alexander-Coleman Individual Corporate Officer May 1, 2009
Brooks Trotter Individual Corporate Officer May 1, 2012
Scott Falgoust Individual Corporate Officer May 31, 2018
Access Health Louisiana Organization, Destrehan, LA Non-profit Operational/Managerial Control Apr 1, 2003
Mark Francis Keiser Individual 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
Kenner Community Health CenterKenner, LA, CCN 191096 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

Facilities with the same owner 3

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

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1114684859",
    "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": "1 WILDCAT LN",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700474001",
            "telephone_number": "866-530-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "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": "504-575-3700"
    },
    "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": "Destrehan High SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Destrehan, LA

Sources for this page

Verify at the official NPI Registry.