Access Health Louisiana

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ACCESS HEALTH LOUISIANA

Doing business as

St Charles Community Health Center, Norco

Practice address

16004 River Rd
Norco, LA 70079-2040

Phone

(985) 725-9330

Fax

(504) 575-3691

NPI assigned

Mar 13, 2009

Last updated

Aug 19, 2016By the provider in NPPES

Organization subpart

No

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 1

Addresses

Other identifiers 1

Other names 1

• St Charles Community Health Center, Norco Doing business as

Medicare fee-for-service enrollment

Enrolled in LA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376784868. Details of each certification follow.

• CCN 191865 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 191865

Legal name

ACCESS HEALTH LOUISIANA

Doing business as

NORCO COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 7, 2009

Last certification

May 7, 2009

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

in LA

Enrollment address

16004 River Rd
Norco Community Health Center
Norco, LA 70079-2040

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

CLIA laboratory certificates

All disclosed owners & managing parties 12

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

All facility ownership & control disclosures 4

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

Practitioners 8

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.

• Jonathan Nicholas Chandler, PSYD, MP

  • Prescribing (Medical) Psychologist
  • New Orleans, LA
  • NPI 1558647891
  Medicare reassignment NPD
• Chemmale Jayakrishnan

  • Specialist
  • Luling, LA
  • NPI 1376635607
  Medicare reassignment NPD
• Tamira Leblanc, NP

  • Family Nurse Practitioner
  • Westwego, LA
  • NPI 1023587433
  Medicare reassignment NPD
• Sudha Mardia, M.D.

  • Family Medicine Physician
  • Luling, LA
  • NPI 1467445213
  Medicare reassignment NPD
• Christine Dessauer McDaniel, PAC

  • Physician Assistant
  • Larose, LA
  • NPI 1508913195
  Medicare reassignment NPD
• Yacara Tabb, DPM

  • Podiatrist
  • Luling, LA
  • NPI 1942275367
  Medicare reassignment NPD
• Robert Earl Dawson, MD

  • Internal Medicine Physician
  • Luling, LA
  • NPI 1992800189
  NPD (past)
• Angela E Green, DO

  • Psychiatry Physician
  • New Orleans, LA
  • NPI 1114196995
  NPD (past)

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1376784868",
    "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": "16004 RIVER RD",
            "city": "NORCO",
            "state": "LA",
            "postal_code": "700792040",
            "telephone_number": "985-725-9330",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2016-08-19",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1579483",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Charles Community Health Center, Norco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Access Health Louisiana (Norco Adult Day Care)
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• Ascend Therapy Services, LLC
• Angela Barre
• Danielle Barrios

• Federally Qualified Health Center (FQHC) in Norco, LA
• Providers in Norco, LA by specialty
• Federally Qualified Health Center (FQHC) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.