NPIMap

Organization Active NPI

St James Parish Hosp Serv Dist

Doing business as SJPH Physician Clinics

  • Rural Health Clinic/Center
  • Vacherie, LA
National Provider Identifier
1518364801
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST JAMES PARISH HOSP SERV DIST
Doing business as
SJPH Physician Clinics
Practice address
21420 Highway 20
Vacherie, LA 70090-3614
Phone
(225) 265-3013
Fax
(225) 265-3775
NPI assigned
Dec 2, 2014
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Ms. Mary Ellen Pratt
Title
Ceo
Phone
(225) 258-5900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Nurse Practitioner 363LF0000X NU
General Practice Physician 208D00000X NU

Addresses

Primary practice location

21420 Highway 20
Vacherie, LA 70090-3614

Mailing address

1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone (225) 258-5906

Other names 1

  • SJPH Physician Clinics Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031208000748 LA Part B Supplier - Clinic/Group Practice 3476459850 Receives reassigned benefits from 13 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lutcher, LA; Vacherie, LA
O20241029002214 LA Part A Provider - Rural Health Clinic 3476459850 Practice locations: Vacherie, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1518364801. Details of each certification follow.

Rural health clinic certification: CCN 198553

Legal name
ST. JAMES PARISH HOSP SERV DIST
Doing business as
ST. JAMES WEST BANK CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 5, 2025
Last certification
May 5, 2025
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
21420 Highwary 20
Vacherie, LA 70090-3614
Related CCNs
191305

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
St James Parish Hosp SE6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

21420 Highway 20
Vacherie, LA 70090
Phone (225) 258-5910

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Mary Pratt Individual W-2 Managing EmployeeChief Executive Officer Dec 31, 2024
Ethan Bland Individual W-2 Managing EmployeeChief Financial Officer Jul 1, 2025
Tracy George Individual W-2 Managing EmployeeChief Financial Officer Dec 31, 2024

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
St. James Parish HospitalLutcher, LA, CCN 191305 Hospital Operational/Managerial Control Apr 15, 2008
St. James Parish Hosp Serv DistLutcher, LA, CCN 19Z305 Hospital Operational/Managerial Control Apr 15, 2008

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1518364801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-258-5906",
            "fax_number": "225-869-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21420 HIGHWAY 20",
            "city": "VACHERIE",
            "state": "LA",
            "postal_code": "700903614",
            "telephone_number": "225-265-3013",
            "fax_number": "225-265-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JAMES PARISH HOSP SERV DIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "MARY ELLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-258-5900",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJPH Physician Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacherie, LA

Sources for this page

Verify at the official NPI Registry.