NPIMap

Organization Active NPI

Teche Action Board Inc

Doing business as Teche Health @ Morgan City

  • Federally Qualified Health Center (FQHC)
  • Morgan City, LA
National Provider Identifier
1124307566
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TECHE ACTION BOARD INC
Doing business as
Teche Health @ Morgan City
Practice address
1124 7TH St
Morgan City, LA 70380-1951
Phone
(985) 384-2371
Fax
(985) 384-2645
NPI assigned
Aug 16, 2011
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
TECHE ACTION BOARD INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Mr. Gary M Wiltz, MDNPI 1477596351
Title
Ceo
Phone
(337) 828-2550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1124 7TH St
Morgan City, LA 70380-1951

Mailing address

1115 Weber St
Franklin, LA 70538-4124
Phone (337) 828-2550

Other identifiers 2

IdentifierTypeStateIssuer
5B803OtherLAMEDICARE PART B
2195417MedicaidLA

Other names 1

  • Teche Health @ Morgan City Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041109000792 LA Part B Supplier - Clinic/Group Practice 0648163980 Receives reassigned benefits from 39 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Place, LA; Vacherie, LA; Thibodaux, LA; Reserve, LA; Pierre Part, LA; Morgan City, LA; Houma, LA; Gramercy, LA…
O20120127000498 LA Part A Provider - Federally Qualified Health Center (FQHC) 0648163980 Practice locations: Morgan City, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124307566. Details of each certification follow.

Federally qualified health center certification: CCN 191890

Legal name
TECHE ACTION BOARD INC
Doing business as
TECHE HEALTH @ MORGAN CITY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 27, 2012
Last certification
Jan 27, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1124 7TH St
Morgan City, LA 70380-1951

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Teche Action Board Inc15 organizations share this tax ID, including this one
Part of
Teche Action Board Inc

Other organizations with this tax ID 14

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

View all 14

Locations

1709 Ridgefield Rd
Thibodaux, LA 70301
Phone 33782825502144

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Willie Rack Individual Corporate DirectorBoard Member Dec 5, 2011
Howard Castay Individual Corporate DirectorBoard Member Dec 5, 2011
Berryl Broussard Individual W-2 Managing EmployeeChief Legal Officier May 3, 2021
Thomas Dardar Individual Corporate DirectorBoard Member Dec 5, 2011
Barbara Hills Individual Corporate OfficerSecretary Dec 5, 2011
Eugene Dial Individual Corporate Director Jan 3, 2022
Leroy Willis Individual Corporate OfficerPresident Dec 5, 2011
Edna Lyons Individual Corporate DirectorBoard Member Dec 5, 2011
Darrell Jupiter Individual Corporate DirectorBoard Member Dec 5, 2011
Denise Pitts Individual Corporate DirectorBoard Member Dec 5, 2011
Nikina Vilcan Individual W-2 Managing EmployeeCfo Mar 16, 2020
Rose Dorsey Individual Corporate OfficerTreasurer Dec 5, 2011
Gary M Wiltz Individual W-2 Managing EmployeeCeo Dec 5, 2011
Operational/Managerial ControlCeo Dec 5, 2011
Donnie Frizzell Individual Corporate DirectorBoard Member Dec 5, 2011
Athan J Olivier Individual W-2 Managing EmployeeCoo Apr 22, 2025

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1124307566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WEBER ST",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550",
            "fax_number": "337-355-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 7TH ST",
            "city": "MORGAN CITY",
            "state": "LA",
            "postal_code": "703801951",
            "telephone_number": "985-384-2371",
            "fax_number": "985-384-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECHE ACTION BOARD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TECHE ACTION BOARD INC",
        "enumeration_date": "2011-08-16",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "WILTZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-828-2550",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "5B803",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195417",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teche Health @ Morgan City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morgan City, LA

Sources for this page

Verify at the official NPI Registry.