NPIMap

Organization Active NPI

Council for Advancement of Social Service and Education

Doing business as CASSE - DIAMC Health Center

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
National Provider Identifier
1467061515
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Doing business as
CASSE - DIAMC Health Center
Practice address
1560 Irving Place
Shreveport, LA 71101-4604
Phone
(318) 688-3350
NPI assigned
Jul 24, 2020
Last updated
Jul 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Authorized official

Name
Mrs. Mary M Chumley, RN
Title
Ceo
Phone
(318) 688-3350

Specialties & licenses 1

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

Addresses

Primary practice location

1560 Irving Place
Shreveport, LA 71101-4604

Mailing address

2120 Bert Kouns Industrial Loop Ste H
Shreveport, LA 71118-3354
Phone (318) 688-3350

Other names 1

  • CASSE - DIAMC 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
O20210427001257 LA Part A Provider - Federally Qualified Health Center (FQHC) 8022043710 Practice locations: Shreveport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467061515. Details of each certification follow.

Federally qualified health center certification: CCN 191076

Legal name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Organization structure
CorporationNon-profit
Enrollment address
1560 Irving PL
Shreveport, LA 71101-4604

Other NPIs with the same Medicare PAC ID 5

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

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
19D2213055Casse - Diamc Family Health Center1560 Irving Place, Shreveport, LA 71101Certificate of waiverFeb 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Council for the Advancement of Social Servies and Education10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

2120 Bert Kouns Industrial Loop
Ste A
Shreveport, LA 71118
Phone (318) 688-3350

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Mary M Chumley Individual W-2 Managing Employee Sep 1, 2020

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Casse Community Health InstituteMansfield, LA, CCN 191883 Federally qualified health center Operational/Managerial Control Feb 13, 2006

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1467061515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BERT KOUNS INDUSTRIAL LOOP STE H",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183354",
            "telephone_number": "318-688-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 IRVING PLACE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014604",
            "telephone_number": "318-688-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "CHUMLEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-688-3350",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "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": "CASSE - DIAMC Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.