NPIMap

Organization Active NPI

Teche Action Board, Inc.

Doing business as Teche Health @ ST. James High School

  • Federally Qualified Health Center (FQHC)
  • Vacherie, LA
National Provider Identifier
1649914763
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TECHE ACTION BOARD, INC.
Doing business as
Teche Health @ ST. James High School
Practice address
22187 Highway 20
Vacherie, LA 70090-3621
Phone
(225) 258-4980
NPI assigned
Apr 25, 2022
Last updated
Aug 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
TECHE ACTION BOARD, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Authorized official

Name
Shannon Verdun
Title
Privileging & Credentialing Manager
Phone
(337) 828-2550

Specialties & licenses 1

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

Addresses

Primary practice location

22187 Highway 20
Vacherie, LA 70090-3621

Mailing address

1115 Weber St
Franklin, LA 70538-4124
Phone (337) 828-2550

Other names 1

  • Teche Health @ ST. James High School Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041109000792 LA Part B Supplier - Clinic/Group Practice 0648163980 Receives reassigned benefits from 39 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Place, LA; Vacherie, LA; Thibodaux, LA; Reserve, LA; Pierre Part, LA; Morgan City, LA; Houma, LA; Gramercy, LA…
O20220921003974 LA Part A Provider - Federally Qualified Health Center (FQHC) 0648163980 Practice locations: Vacherie, LA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1649914763. Details of each certification follow.

Federally qualified health center certification: CCN 191190

Legal name
TECHE ACTION BOARD INC
Doing business as
TECHE HEALTH @ ST. JAMES HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 6, 2022
Last certification
Sep 6, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
22187 Highway 20
Vacherie, LA 70090-3621

Federally qualified health center certification: CCN 191109

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
TECHE ACTION BOARD INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 6, 2022
Last certification
Sep 6, 2022
Ownership / control type
For profit – corporation
Facility address
22187 Highway 20
Vacherie, LA 70090

Other NPIs with the same Medicare PAC ID 11

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

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Teche Action Clinic16 organizations share this tax ID, including this one
Part of
Teche Action Clinic

Other organizations with this tax ID 15

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

View all 15

Locations

5642 W Main St
Houma, LA 70360
Phone (985) 448-3737

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Willie Rack Individual Corporate Director Apr 25, 2022
Shannon Verdun Individual W-2 Managing Employee Apr 25, 2022
Howard Castay Individual Corporate Director Apr 25, 2022
Berryl Broussard Individual W-2 Managing EmployeeChief Legal Officier Apr 25, 2022
Thomas Dardar Individual Corporate Director Apr 25, 2022
Barbara Hills Individual Corporate Officer Apr 25, 2022
Eugene Dial Individual Corporate Director Apr 25, 2022
Leroy Willis Individual Corporate Officer Apr 25, 2022
Edna Lyons Individual Corporate Director Apr 25, 2022
Darrell Jupiter Individual Corporate Director Apr 25, 2022
Denise Pitts Individual Corporate Director Apr 25, 2022
Nikina Vilcan Individual W-2 Managing Employee Apr 25, 2022
Rose Dorsey Individual Corporate Officer Apr 25, 2022
Gary M Wiltz Individual W-2 Managing Employee Apr 25, 2022
Operational/Managerial ControlCeo Apr 25, 2022
Donnie Frizzell Individual Corporate Director Apr 25, 2022
Athan J Olivier Individual W-2 Managing EmployeeCoo Apr 22, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1649914763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WEBER ST",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550",
            "fax_number": "337-355-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22187 HIGHWAY 20",
            "city": "VACHERIE",
            "state": "LA",
            "postal_code": "700903621",
            "telephone_number": "225-258-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECHE ACTION BOARD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TECHE ACTION BOARD, INC.",
        "enumeration_date": "2022-04-25",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A",
        "authorized_official_last_name": "VERDUN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PRIVILEGING & CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "337-828-2550"
    },
    "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": "Teche Health @ ST. James High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacherie, LA

Sources for this page

Verify at the official NPI Registry.