NPIMap

Organization Active NPI

Tensas Community Health Center Inc.

Doing business as Vidalia Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Vidalia, LA
National Provider Identifier
1235600990
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TENSAS COMMUNITY HEALTH CENTER INC.
Doing business as
Vidalia Community Health Center
Practice address
900 Carter St Ste a
Vidalia, LA 71373-3208
Phone
(318) 766-1967
NPI assigned
Dec 6, 2018
Last updated
Apr 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
TENSAS COMMUNITY HEALTH CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Authorized official

Name
Dawn C Johnson
Title
Office Manager
Phone
(318) 766-1967

Specialties & licenses 1

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

Addresses

Primary practice location

900 Carter St Ste a
Vidalia, LA 71373-3208

Mailing address

PO Box 46
Saint Joseph, LA 71366-0046
Phone (318) 766-1967

Other names 1

  • Vidalia Community Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100301000042 LA Part B Supplier - Clinic/Group Practice 4385657139 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: St Joseph, LA; Vidalia, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235600990. Details of each certification follow.

  • CCN 191031 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 191031

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VIDALIA COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 29, 2020
Last certification
Jun 29, 2020
Ownership / control type
For profit – corporation
Facility address
900 Carter Street, Suite a
Vidalia, LA 71373

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2226718Vidalia Community Health Center900 Carter Street Ste a, Vidalia, LA 71373Certificate of waiverMay 30, 2028

National Provider Directory

National Provider Directory
Part of
Tensas Comm HLTH Ctr Inc

Locations

1115 Levee Rd
Saint Joseph, LA 71366
Phone (318) 766-1967

900 Carter St
Ste A
Vidalia, LA 71373
Phone (318) 336-4780

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHHACD

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1235600990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46",
            "city": "SAINT JOSEPH",
            "state": "LA",
            "postal_code": "713660046",
            "telephone_number": "318-766-1967",
            "fax_number": "318-766-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CARTER ST STE A",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733208",
            "telephone_number": "318-766-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENSAS COMMUNITY HEALTH CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENSAS COMMUNITY HEALTH CENTER INC.",
        "enumeration_date": "2018-12-06",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-766-1967"
    },
    "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": "Vidalia Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vidalia Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, LA

Sources for this page

Verify at the official NPI Registry.