NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as Washington Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bogalusa, LA
National Provider Identifier
1427488352
Registry record updated Sep 13, 2016
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
Washington Community Health Center
Practice address
2807 S Columbia St
Bogalusa, LA 70427-7915
Phone
(985) 730-7310
Fax
(504) 575-3691
NPI assigned
Nov 13, 2013
Last updated
Sep 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Medicine Physician 207Q00000X MD.023712 LA
Pediatrics Physician 208000000X MD.10981R LA

Addresses

Primary practice location

2807 S Columbia St
Bogalusa, LA 70427-7915

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2352687MedicaidLA

Other names 1

  • Washington Community Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140612000417 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Bogalusa, LA
O20150429001939 LA Part B Supplier - Clinic/Group Practice 3678484276 Receives reassigned benefits from 3 practitioners
Practice locations: Bogalusa, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427488352. Details of each certification follow.

Federally qualified health center certification: CCN 191917

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
WASHINGTON CHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 11, 2014
Last certification
Jun 11, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 21, 2002 in LA
Enrollment address
2807 South Columbia Street
Washington Community Health Center
Bogalusa, LA 70427-7915

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
19D2069685Washington CHC2807 South Columbia Street, Bogalusa, LA 70427Certificate of waiverDec 1, 2027

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

Ownership & related parties

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.

NameRoleSinceShare
Peter Torsch Individual Corporate Director Nov 20, 2015
Germaine L Robottom Individual Corporate Officer Apr 23, 2017
Estelle Alfortish Individual Corporate Officer Apr 23, 2018
Gaynell Alexander-Coleman Individual Corporate Officer Mar 1, 2003
Brooks Trotter Individual Corporate Officer Feb 24, 2011
Scott Falgoust Individual Corporate Officer May 31, 2018
Mark Francis Keiser Individual Corporate Director Dec 17, 2003
W-2 Managing Employee Dec 17, 2003
Sandra Zimmer Individual Corporate Officer Oct 25, 2018
Francesca Vial Individual Corporate Officer Mar 1, 2003
John Cressend Schonberg Individual Corporate Officer Apr 23, 2009
James G Comeaux Individual Corporate Officer Mar 15, 2005
W-2 Managing Employee Mar 15, 2005
Timothy J. Vial Individual Corporate Director Apr 23, 2010

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 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1384300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1427488352",
    "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": "2807 S COLUMBIA ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704277915",
            "telephone_number": "985-730-7310",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-13",
        "last_updated": "2016-09-13",
        "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
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.023712",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.10981R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2352687",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.