NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as East Jefferson High School SBHC

  • Federally Qualified Health Center (FQHC)
  • Metairie, LA
National Provider Identifier
1194355990
Registry record updated Jan 21, 2020
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
East Jefferson High School SBHC
Practice address
400 Phlox Ave
Metairie, LA 70001-4542
Phone
(866) 530-6111
NPI assigned
Jan 21, 2020
Last updated
Jan 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

400 Phlox Ave
Metairie, LA 70001-4542

Mailing address

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

Other names 1

  • East Jefferson High School SBHC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200908000776 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Metairie, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194355990. Details of each certification follow.

Federally qualified health center certification: CCN 191048

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
EAST JEFFERSON HIGH SCHOOL SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 2, 2020
Last certification
Sep 2, 2020
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 1, 2003 in LA
Enrollment address
400 Phlox Ave
Metairie, LA 70001-4542

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

Locations

400 Phlox Ave
Metairie, LA 70001
Phone (504) 259-6190

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 Director Mar 25, 2016
Germaine L Robottom Individual Corporate Officer Apr 23, 2015
Estelle Alfortish Individual Corporate Officer Feb 23, 2017
Gaynell Alexander-Coleman Individual Corporate Officer Mar 1, 2003
Brooks Trotter Individual Corporate Officer Mar 1, 2003
Jesse Babin Individual Corporate OfficerBoard Member Apr 23, 2023
Mark Francis Keiser Individual Corporate Officer Apr 1, 2003
W-2 Managing Employee Apr 1, 2003
Sandra Zimmer Individual Corporate Officer Oct 25, 2018
Billy Raymond Individual Corporate DirectorBoard Member Apr 24, 2025
John Cressend Schonberg Individual Corporate Officer Apr 1, 2003
Timothy J. Vial Individual Corporate Officer Apr 1, 2003

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 36

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 36

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1194355990",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PHLOX AVE",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700014542",
            "telephone_number": "866-530-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-575-3700"
    },
    "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": "East Jefferson High School SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.