NPIMap

Organization Active NPI

Council for Advancement of Social Service and Education

Doing business as CASSE/CHI Bert Kouns Site

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
National Provider Identifier
1134532062
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Doing business as
CASSE/CHI Bert Kouns Site
Practice address
2120 Bert Kouns Industrial Loop
Suite a
Shreveport, LA 71118-3351
Phone
(318) 688-3350
Fax
(318) 688-3655
NPI assigned
Jun 9, 2014
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Mary M Chumley
Title
Ceo/President
Phone
(318) 688-3350

Specialties & licenses 1

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

Addresses

Primary practice location

2120 Bert Kouns Industrial Loop
Suite a
Shreveport, LA 71118-3351

Mailing address

2120 Bert Kouns Industrial Loop
Suite a
Shreveport, LA 71118-3351
Phone (318) 688-3350

Other names 1

  • CASSE/CHI Bert Kouns Site Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051129000114 LA Part B Supplier - Clinic/Group Practice 8022043710 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mansfield, LA; Shreveport, LA
O20160908002074 LA Part A Provider - Federally Qualified Health Center (FQHC) 8022043710 Practice locations: Shreveport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134532062. Details of each certification follow.

Federally qualified health center certification: CCN 191954

Legal name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Doing business as
CASSE COMMUNITY HEALTH INSTITUTE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 7, 2016
Last certification
Sep 7, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 23, 1996 in LA
Enrollment address
2120 Bert Kouns Industrial Loop
Suite a
Shreveport, LA 71118-3351

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Council for Advancement of Social Service and Education10 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

2120 Bert Kouns Industrial Loop
Ste Kl
Shreveport, LA 71118
Phone (318) 688-3350

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Mary M Chumley Individual Corporate OfficerPres/Ceo Dec 23, 1996 100%
W-2 Managing Employee Dec 23, 1996

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Casse Community Health InstituteMansfield, LA, CCN 191883 Federally qualified health center Operational/Managerial Control Feb 13, 2006

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1134532062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183351",
            "telephone_number": "318-688-3350",
            "fax_number": "318-688-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "SUITE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183351",
            "telephone_number": "318-688-3350",
            "fax_number": "318-688-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-09",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "CHUMLEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "318-688-3350"
    },
    "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": "CASSE/CHI Bert Kouns Site",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.