NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as St Bernard Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Chalmette, LA
National Provider Identifier
1174828362
Registry record updated Aug 5, 2016
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
St Bernard Community Health Center
Practice address
8050 W Judge Perez Dr
Suite 1300
Chalmette, LA 70043-1734
Phone
(504) 281-2800
Fax
(504) 575-3691
NPI assigned
Jan 19, 2011
Last updated
Aug 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Authorized official

Name
Mark Keiser
Title
President
Phone
(504) 575-3700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 15628 LA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 20686 LA
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

8050 W Judge Perez Dr
Suite 1300
Chalmette, LA 70043-1734

Mailing address

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

Other names 1

  • St Bernard Community Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110222001071 LA Part B Supplier - Clinic/Group Practice 3678484276 Receives reassigned benefits from 4 practitioners
Practice locations: Arabi, LA; Chalmette, LA
O20120103000734 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Chalmette, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174828362. Details of each certification follow.

Federally qualified health center certification: CCN 191891

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
ST BERNARD CHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 3, 2012
Last certification
Jan 3, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 21, 2002 in LA
Enrollment address
8050 W Judge Perez Dr Ste 1300
Chalmette, LA 70043-1736

National Provider Directory

National Provider Directory
Tax ID family
St Charles Community Health Center Inc89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Ownership & related parties

All disclosed owners & managing parties 11

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 OfficerBoard Member Nov 19, 2015
Germaine L Robottom Individual Corporate OfficerBoard Member Nov 19, 2015
Estelle Alfortish Individual Corporate Officer Feb 23, 2017
Gaynell Alexander-Coleman Individual Corporate Officer Mar 1, 2003
Operational/Managerial ControlBoard Member Mar 1, 2011
Brooks Trotter Individual Corporate OfficerBoard Member Feb 24, 2011
Scott Falgoust Individual Corporate Officer May 31, 2018
Mark Francis Keiser Individual Corporate Director Mar 1, 2002
Sandra Zimmer Individual Corporate Officer Oct 25, 2018
Francesca Vial Individual Corporate Officer Mar 1, 2011
John Cressend Schonberg Individual Corporate Officer Mar 1, 2003
Timothy J. Vial Individual Corporate Officer Mar 1, 2011
Corporate Director Apr 23, 2010

All facility ownership & control disclosures 4

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
Destrehan HS SBHCDestrehan, LA, CCN 191104 Federally qualified health center Operational/Managerial Control Apr 1, 2003

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1174828362",
    "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",
            "fax_number": "504-575-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 W JUDGE PEREZ DR",
            "address_2": "SUITE 1300",
            "city": "CHALMETTE",
            "state": "LA",
            "postal_code": "700431734",
            "telephone_number": "504-281-2800",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-575-3700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "15628",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "20686",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Bernard Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chalmette, LA

Sources for this page

Verify at the official NPI Registry.