NPIMap

Organization Active NPI

HIV-AIDS Alliance for Region Two

Doing business as Open Health Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
National Provider Identifier
1114803905
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HIV-AIDS ALLIANCE FOR REGION TWO
Doing business as
Open Health Care Clinic
Practice address
2585 Brightside Dr RM 114
Baton Rouge, LA 70820-3504
Phone
(225) 655-6422
NPI assigned
Aug 15, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Authorized official

Name
Tim Young
Title
President & Chief Executive Officer
Phone
(225) 424-1800

Specialties & licenses 1

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

Addresses

Primary practice location

2585 Brightside Dr RM 114
Baton Rouge, LA 70820-3504

Mailing address

9516 Airline Hwy
Baton Rouge, LA 70815-5501
Phone (225) 655-6422

Other names 1

  • Open Health Care Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251024001995 LA Part A Provider - Federally Qualified Health Center (FQHC) 4880981158 Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114803905. Details of each certification follow.

Federally qualified health center certification: CCN 711976

Legal name
HIV-AIDS ALLIANCE FOR REGION TWO
Doing business as
OPEN HEALTH CARE CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 29, 2025
Last certification
Aug 29, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2585 Brightside Dr
RM 114
Baton Rouge, LA 70820-3504

Other NPIs with the same Medicare PAC ID 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Hivaids Alliance for Region Two Inc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1735 Thomas H Delpit Dr
Baton Rouge, LA 70802
Phone (225) 424-1743

2585 Brightside Dr
Rm 114
Baton Rouge, LA 70820

2751 Wooddale Blvd
Ste C
Baton Rouge, LA 70805
Phone (225) 663-6333

3905 Convention St
Baton Rouge, LA 70806
Phone (225) 387-7858

5601 Upton Dr
Rm D117
Baton Rouge, LA 70809

6450 Guynell Dr
Rm 101
Baton Rouge, LA 70811

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Cassandra Whitty Individual Corporate OfficerDirector May 1, 2007
Bryan Jeansonne Individual Corporate OfficerBoard Member Jun 1, 2022
Maria Pons Individual Corporate OfficerDirector Jun 1, 2021
Billy Dudley Individual Corporate OfficerBoard Chairman Jun 1, 2015
HIV-AIDS Alliance for Region Two Organization, Baton Rouge, LA Non-profit 5% Or Greater Indirect Ownership Interest Aug 14, 2025 100%
Timothy Young Individual Corporate DirectorPresident & Chief Executive Officer Sep 1, 1996 100%
Keisha Brockington Individual Corporate OfficerDirector Oct 1, 2023
Dawn Beasley Individual W-2 Managing Employee Oct 1, 2015
David Lance Individual Corporate OfficerDirector Oct 1, 2024
Pamala Ellis Individual Corporate OfficerParliamentarian Aug 1, 2004
Sherry Lassere Individual Corporate OfficerDirector Oct 1, 2016
Matthew Walton Individual Corporate OfficerTreasurer Apr 1, 2023
Walthena Gosa Individual Corporate OfficerBoard Member Apr 1, 2023

Owners & managing parties with NPI records 13

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

View all 13

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Open Health Care ClinicBaton Rouge, LA, CCN 191955 Federally qualified health center 5% Or Greater Indirect Ownership Interest Jan 1, 2017
Open Health Care ClinicBaton Rouge, LA, CCN 191050 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jun 1, 2020
Open Health Care ClinicDenham Springs, LA, CCN 191088 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2020
Open Health Care ClinicBaton Rouge, LA, CCN 191107 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2022
Open Health Care ClinicEunice, LA, CCN 191154 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Sep 25, 2023
Open Health Care ClinicBaton Rouge, LA, CCN 191177 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 28, 2023
Open Health Care ClinicBaton Rouge, LA, CCN 191176 Federally qualified health center 5% Or Greater Indirect Ownership Interest (100%) Jan 19, 2024

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755216000000",
    "number": "1114803905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9516 AIRLINE HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708155501",
            "telephone_number": "225-655-6422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 BRIGHTSIDE DR RM 114",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708203504",
            "telephone_number": "225-655-6422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIV-AIDS ALLIANCE FOR REGION TWO",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "225-424-1800"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Open Health Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.