NPIMap

Organization Active NPI

Priority Health Care

  • Federally Qualified Health Center (FQHC)
  • Marrero, LA
National Provider Identifier
1609136563
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIORITY HEALTH CARE
Practice address
4700 Wichers Dr # 304-305
Marrero, LA 70072-3041
Phone
(504) 309-3262
Fax
(504) 309-9307
NPI assigned
May 24, 2012
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Mrs. Tamara Boutte Dioubate, MSW, MSHCM
Title
Ceo
Phone
(504) 309-6522

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X
Federally Qualified Health Center (FQHC) 261QF0400X LA Primary

Addresses

Primary practice location

4700 Wichers Dr # 304-305
Marrero, LA 70072-3041

Mailing address

4700 Wichers Dr Ste 306
Marrero, LA 70072-3054
Phone (504) 309-6522

Other names 1

  • Marrero Site Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131205000208 LA Part B Supplier - Clinic/Group Practice 5395972988 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
Practice locations: Gretna, LA; Marrero, LA
O20160218000518 LA Part A Provider - Federally Qualified Health Center (FQHC) 5395972988 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marrero, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609136563. Details of each certification follow.

Federally qualified health center certification: CCN 191946

Legal name
PRIORITY HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 27, 2016
Last certification
Jan 27, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 2009 in LA
Enrollment address
4700 Wichers Dr
Ste 304-305
Marrero, LA 70072-3041

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Locations

4700 Wichers Dr
#304305
Marrero, LA 70072
Phone (504) 309-3262

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Tyra Trenise Brown Individual Corporate DirectorGoverning Board Chair Aug 25, 2009
Monique Williams- Johnson Individual Corporate DirectorGoverning Board Member Aug 20, 2020
Tamara B Dioubate Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Aug 25, 2009 100%
W-2 Managing EmployeeChief Executive Officer Aug 25, 2009
Hiram Mitchell Walker Individual Corporate DirectorGoverning Board Member Aug 20, 2020
Daniel Lewis Individual Corporate DirectorGoverning Board Treasurer Sep 1, 2017
Larrion Dean Individual Corporate DirectorGoverning Board Member Sep 1, 2018
Fabian Ancar Individual Corporate DirectorGoverning Board Member May 1, 2019
Mervin Douglas Individual Corporate DirectorGoverning Board Member Jan 1, 2016
Arisa Banks Individual Corporate DirectorAbforestesq@Protonmail.Com Dec 1, 2016
Cynthia Simmons Individual Corporate DirectorGoverning Board Parliamentarian Oct 1, 2018

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1609136563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WICHERS DR STE 306",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723054",
            "telephone_number": "504-309-6522",
            "fax_number": "504-309-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WICHERS DR # 304-305",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723041",
            "telephone_number": "504-309-3262",
            "fax_number": "504-309-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIORITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2025-09-02",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "DIOUBATE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "BOUTTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-309-6522",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, MSHCM"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marrero Site",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.