NPIMap

Organization Active NPI

Southern Regional Medical Corporation

Doing business as Leonard J. Chabert Medical Center Psych

  • Psychiatric Hospital Unit
  • Houma, LA
National Provider Identifier
1689011280
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
SOUTHERN REGIONAL MEDICAL CORPORATION
Doing business as
Leonard J. Chabert Medical Center Psych
Practice address
1978 Industrial Blvd
Houma, LA 70363-7055
Phone
(985) 873-1282
NPI assigned
May 23, 2013
Last updated
May 19, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN REGIONAL MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Authorized official

Name
Phyllis Peoples
Title
President and Ceo
Phone
(985) 873-4620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

1978 Industrial Blvd
Houma, LA 70363-7055

Mailing address

8166 Main St
Houma, LA 70360-3404
Phone (985) 873-4141

Other identifiers 1

IdentifierTypeStateIssuer
1705136MedicaidLA

Other names 1

  • Leonard J. Chabert Medical Center Psych Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140203001712 LA Part A Provider - Hospital 6305086349 Practice locations: Houma, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689011280. Details of each certification follow.

Hospital certification: CCN 19S183

Legal name
SOUTHERN REGIONAL MEDICAL CORPORATION
Doing business as
LEONARD J. CHABERT MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
May 7, 2013 in LA
Enrollment address
1978 Industrial Boulevard
Psychiatry Unit
Houma, LA 70363-7055
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Southern Regional Medical Corporation4 organizations share this tax ID, including this one
Part of
Southern Regional Medical Corporation

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

114 Picone Rd
Houma, LA 70363
Phone (985) 873-1285

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Frances Diane Yeates Individual Corporate OfficerExecutive Chief Operating Office Jun 24, 2013
Arlanda Jewel Williams Individual Corporate DirectorBoard Member Jul 29, 2022
Michael F Hulefeld Individual Operational/Managerial ControlPresident & Chief Operating Officer Jun 24, 2013
OtherChain Home Office Administrator Jun 24, 2013
Angelique T Barker Individual Corporate Director Aug 23, 2013
Chabert Operational Managmement Company LLC Organization, New Orleans, LA LLC Operational/Managerial Control Jun 24, 2013
Bernadette Robinett Pickett Individual Corporate Director Jul 28, 2015
Mike Fakier Individual Corporate Director Mar 20, 2013
Tanner D Magee Individual Corporate DirectorBoard Member Jul 29, 2022
Robert Don Ross Individual Corporate DirectorBoard Member Feb 7, 2022
Shane S Robichaux Individual Corporate OfficerAdministrator Jan 11, 2023
W-2 Managing EmployeeAdministrator Jan 11, 2023
Operational/Managerial ControlAdministrator Jan 11, 2023
Ben B Adams Individual Corporate DirectorBoard Member Aug 12, 2020
Terrebonne Parish Hospital Service District #1 Organization, Houma, LA 5% Or Greater Direct Ownership Interest Jun 24, 2013 100%
Operational/Managerial Control Jun 24, 2013
Kerry Chauvin Individual Corporate DirectorBoard Member Aug 12, 2020
Ochsner Clinic Foundation Organization, New Orleans, LA Corporation, Non-profit Operational/Managerial Control Jan 1, 2018
Other Jan 1, 2018
Earl Eues Individual Corporate DirectorBoard Member Aug 1, 2019
Michael Bergeron Individual Corporate Director Jul 29, 2016
Robert M Alexander Individual Corporate Director Aug 12, 2015
Phyllis Peoples Individual Corporate OfficerExecutive Chief Executive Office Jun 24, 2013

Owners & managing parties with NPI records 7

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

Facilities with the same owner 76

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 76

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1369267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1689011280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8166 MAIN ST",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703603404",
            "telephone_number": "985-873-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1978 INDUSTRIAL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703637055",
            "telephone_number": "985-873-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN REGIONAL MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN REGIONAL MEDICAL CORPORATION",
        "enumeration_date": "2013-05-23",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "PEOPLES",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "985-873-4620"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1705136",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Leonard J. Chabert Medical Center Psych",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Leonard J. Chabert Medical Center Psych",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.