NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as Avoyelles Public Charter SBHC

  • Federally Qualified Health Center (FQHC)
  • Mansura, LA
National Provider Identifier
1407575608
Registry record updated Aug 23, 2022
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
Avoyelles Public Charter SBHC
Practice address
201 Longfellow Rd
Mansura, LA 71350-4292
Phone
(504) 575-3712
NPI assigned
Aug 23, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 NU Primary

Addresses

Primary practice location

201 Longfellow Rd
Mansura, LA 71350-4292

Mailing address

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

Other names 1

  • Avoyelles Public Charter SBHC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230712003568 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Mansura, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407575608. Details of each certification follow.

Federally qualified health center certification: CCN 191128

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
AVOYELLES PUBLIC CHARTER SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 6, 2023
Last certification
Jul 6, 2023
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Mar 1, 2002 in LA
Enrollment address
201 Longfellow Rd
Mansura, LA 71350-4292

National Provider Directory

National Provider Directory
Tax ID family
Access Health Louisiana89 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 4

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 OfficerCfo Nov 19, 2015
Corporate DirectorCfo Nov 19, 2015
Mark Francis Keiser Individual Corporate OfficerCeo Mar 1, 2002
Corporate DirectorCeo Mar 1, 2002
W-2 Managing EmployeeCeo Mar 1, 2002
John Cressend Schonberg Individual Corporate OfficerVice Chairman of the Board Mar 1, 2002
Timothy J. Vial Individual Corporate OfficerChairman of the Board Mar 1, 2002

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

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1407575608",
    "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": "201 LONGFELLOW RD",
            "city": "MANSURA",
            "state": "LA",
            "postal_code": "713504292",
            "telephone_number": "504-575-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avoyelles Public Charter SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansura, LA

Sources for this page

Verify at the official NPI Registry.