Active NPI
Chitimacha Tribe of Louisiana
- Clinic/Center
- Charenton, LA
National Provider Identifier
1154477909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 15134R
- Legal business name
- CHITIMACHA TRIBE OF LOUISIANA
- Practice address
- 3231 Chitimacha Trail
Charenton, LA 70523-0661 - Phone
- (337) 923-9955
- Fax
- (337) 923-6848
- NPI assigned
- Jan 26, 2007
- Organization subpart
- Yes
- Parent organization
- CHITIMACHA TRIBE OF LOUISIANA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Tricia Lynn Mora
- Title
- Director Health and Human Services
- Phone
- (337) 923-9955
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 15134R | LA | Primary |
Addresses
Primary practice location
3231 Chitimacha Trail
Charenton, LA 70523-0661
Mailing address
PO Box 640
Charenton, LA 70523-0640
Phone (337) 923-9955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1233978 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Chitimacha Tribe of la
- Part of
- Chitimacha Tribe of la
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic Pharmacy
- Charenton, LA
- NPI 1255401022
Locations
3231 Chitimacha Trl
Jeanerette, LA 70544
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Registered Dietitian
- Lafayette, LA
- NPI 1275759946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1371686400000",
"number": "1154477909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 640",
"city": "CHARENTON",
"state": "LA",
"postal_code": "705230640",
"telephone_number": "337-923-9955",
"fax_number": "337-923-6848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3231 CHITIMACHA TRAIL",
"city": "CHARENTON",
"state": "LA",
"postal_code": "705230661",
"telephone_number": "337-923-9955",
"fax_number": "337-923-6848"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHITIMACHA TRIBE OF LOUISIANA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CHITIMACHA TRIBE OF LOUISIANA",
"enumeration_date": "2007-01-26",
"last_updated": "2013-06-20",
"status": "A",
"authorized_official_last_name": "MORA",
"authorized_official_first_name": "TRICIA",
"authorized_official_middle_name": "LYNN",
"authorized_official_title_or_position": "DIRECTOR HEALTH AND HUMAN SERVICES",
"authorized_official_telephone_number": "337-923-9955",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "LA",
"license": "15134R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1233978",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charenton, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.