NPIMap

Organization Active NPI

Southeast Community Health Systems

Doing business as Southeast Community Health Systems @ Albany

  • Federally Qualified Health Center (FQHC)
  • Hammond, LA
National Provider Identifier
1366617367
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHEAST COMMUNITY HEALTH SYSTEMS
Doing business as
Southeast Community Health Systems @ Albany
Practice address
30575 Old Baton Rouge Highway
Hammond, LA 70403
Phone
(225) 306-2050
Fax
(225) 567-6962
NPI assigned
Apr 30, 2008
Last updated
Mar 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Authorized official

Name
Dr. Alecia Cyprian, PHD
Title
Ceo
Phone
(225) 306-2000

Specialties & licenses 1

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

Addresses

Primary practice location

30575 Old Baton Rouge Highway
Hammond, LA 70403

Mailing address

PO Box 770
Zachary, LA 70791-0770
Phone (225) 306-2000

Other names 1

  • Southeast Community Health Systems @ Albany Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120808000592 LA Part B Supplier - Clinic/Group Practice 4284610437 Receives reassigned benefits from 31 practitioners
2 other NPIs on this enrollment
Practice locations: Hammond, LA; Independence, LA; Zachary, LA
O20130528000248 LA Part A Provider - Federally Qualified Health Center (FQHC) 4284610437 Practice locations: Hammond, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366617367. Details of each certification follow.

Federally qualified health center certification: CCN 191895

Legal name
SOUTHEAST COMMUNITY HEALTH SYSTEMS
Doing business as
ALBANY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 28, 2013
Last certification
May 28, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 28, 1992 in LA
Enrollment address
30575 Old Baton Rouge Hwy
Hammond, LA 70403-8350

Other NPIs with the same Medicare PAC ID 22

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

View all 22

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Albany Dental Clinic37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Locations

30575 Old Baton Rouge Hwy
Hammond, LA 70403
Phone (225) 306-2050

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Terry Addison Individual Corporate OfficerBoard Member Jul 26, 2016
Mira L Robertson Individual Operational/Managerial ControlBoard Member Apr 20, 2026
Rochell Bates Individual Operational/Managerial ControlBoard Member Apr 20, 2026
Major Coleman Individual Corporate OfficerBoard Member Jan 1, 2008
Southeast Community Health Systems Organization, Baton Rouge, LA Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2013 100%
Margaret Smith Individual Operational/Managerial ControlBoard Member Apr 20, 2026
Michael Martin Individual Corporate OfficerBoard Chairman Jan 1, 2007
Alecia Cyprian Individual Corporate DirectorCeo Nov 1, 2014
Virginia Reeves Foster Individual W-2 Managing EmployeeCredentialing Specialist Apr 20, 2025
Paula McNabb Individual Corporate OfficerBoard Member Jan 1, 2012
Reyna E Lopez Individual Corporate OfficerBoard Member Jun 7, 2016
Sandy K Tillery Individual Corporate OfficerBoard Member Mar 17, 2020
Dameon Jackson Individual Corporate OfficerBoard Member Jan 1, 2012

Owners & managing parties with NPI records 22

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 22

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
KentwoodKentwood, LA, CCN 191841 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2008
IndependenceIndependence, LA, CCN 191918 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2008
WMGHammond, LA, CCN 191965 Federally qualified health center 5% Or Greater Direct Ownership Interest Jan 1, 2008

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1366617367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707910770",
            "telephone_number": "225-306-2000",
            "fax_number": "225-658-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30575 OLD BATON ROUGE HIGHWAY",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "70403",
            "telephone_number": "225-306-2050",
            "fax_number": "225-567-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST COMMUNITY HEALTH SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "CYPRIAN",
        "authorized_official_first_name": "ALECIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-306-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "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": "Southeast Community Health Systems @ Albany",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.