Active NPI
Commcare Corporation
Doing business as Camelot Community Care
- Skilled Nursing Facility
- Ponchatoula, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- COMMCARE CORPORATION
- Doing business as
- Camelot Community Care
Ponchatoula Community Care Center - Practice address
- 1560 Hwy 51
Ponchatoula, LA 70454-1560 - Phone
- (985) 229-2112
- Fax
- (985) 229-6992
- NPI assigned
- Jul 24, 2018
- Last updated
- Jun 9, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dawn Harvey Psarellis
- Title
- Chief Administrative Officer
- Phone
- (504) 324-8950
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
1560 Hwy 51
Ponchatoula, LA 70454-1560
Mailing address
950 W Causeway Approach
Mandeville, LA 70471-3082
Phone (504) 324-8950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1515027 | Medicaid | LA |
Other names 2
- Camelot Community Care
- Ponchatoula Community Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211102000350 | LA | Part A Provider - Skilled Nursing Facility | 3375437932 | Practice locations: Ponchatoula, LA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1710464664. Details of each certification follow.
Skilled nursing facility certification: CCN 195543
- Legal name
- COMMCARE CORPORATION
- Doing business as
- PONCHATOULA COMMUNITY CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 17, 2002
- Last certification
- Aug 15, 2024
- Beds
- 140
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Comm Care Corporation
- Organization structure
- Corporation
- Incorporated
- Jan 12, 1984 in LA
- Enrollment address
- 1560 Highway 51
Ponchatoula, LA 70454-6373 - Nursing home name
- PONCHATOULA COMMUNITY CARE CENTER
- Affiliated entity
- COMMCARE CORPORATION
Other NPIs with the same Medicare PAC ID 14
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba St. Anthony Community Care Center
- Skilled Nursing Facility
- Metairie, LA
- NPI 1588647564
3375437932
-
dba Greenbriar Community Care Center
- Skilled Nursing Facility
- Slidell, LA
- NPI 1083650840
3375437932
-
dba Calcasieu Community Care Center
- Skilled Nursing Facility
- Lake Charles, LA
- NPI 1114102738
3375437932
-
dba Chateau de Notre Dame Community Care Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1215093943
3375437932
-
dba Wynhoven Community Care Center
- Skilled Nursing Facility
- Marrero, LA
- NPI 1245231992
3375437932
-
dba Ridgecrest Community Care Center
- Skilled Nursing Facility
- West Monroe, LA
- NPI 1316905870
3375437932
-
dba Community Care Center of Baker
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1407813652
3375437932
-
dba Old Brownlee Community Care Center
- Skilled Nursing Facility
- Bossier City, LA
- NPI 1518905983
3375437932
-
dba Trinity Trace Community Care Center
- Skilled Nursing Facility
- Covington, LA
- NPI 1528000965
3375437932
-
dba Heritage Manor Natchitoches Rehab & Retirement Center
- Skilled Nursing Facility
- Natchitoches, LA
- NPI 1588622286
3375437932
-
dba Tioga Community Care Center
- Skilled Nursing Facility
- Pineville, LA
- NPI 1619935905
3375437932
-
dba Baton Rouge Health Care Center
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1639136989
3375437932
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Ponchatoula Community Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Apr 17, 2002
- Medicare certification status
- Active
- Certified beds
- 140
- Chain
- Commcare Corporation
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D2340613 | Ponchatoula Community Care Center | Certificate of waiver | Mar 18, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Community Care Center O
Other organizations with this tax ID 18
Organizations that report the same tax identification number in the National Provider Directory.
-
dba DBA Cmhc of Alexandria
- Adult Mental Health Clinic/Center
- Alexandria, LA
- NPI 1508083114
-
dba Community Care Center of Ruston
- Skilled Nursing Facility
- Ruston, LA
- NPI 1487680823
-
dba St. Anthony Community Care Center
- Skilled Nursing Facility
- Metairie, LA
- NPI 1588647564
-
dba Greenbriar Community Care Center
- Skilled Nursing Facility
- Slidell, LA
- NPI 1083650840
-
dba Calcasieu Community Care Center
- Skilled Nursing Facility
- Lake Charles, LA
- NPI 1114102738
-
dba Chateau de Notre Dame Community Care Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1215093943
-
dba Wynhoven Community Care Center
- Skilled Nursing Facility
- Marrero, LA
- NPI 1245231992
-
dba Ridgecrest Community Care Center
- Skilled Nursing Facility
- West Monroe, LA
- NPI 1316905870
-
dba Community Care Center of Baker
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1407813652
-
dba Old Brownlee Community Care Center
- Skilled Nursing Facility
- Bossier City, LA
- NPI 1518905983
-
dba Trinity Trace Community Care Center
- Skilled Nursing Facility
- Covington, LA
- NPI 1528000965
-
dba Heritage Manor Natchitoches Rehab & Retirement Center
- Skilled Nursing Facility
- Natchitoches, LA
- NPI 1588622286
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Community Care Center of Baker
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1407813652
Member Of
Ownership & related parties
All disclosed owners & managing parties 8
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Alec Lundberg | W-2 Managing Employee | May 1, 2021 | |
| Michael a Ford | Corporate Director | May 1, 2021 | 25% |
| Dawn R Harvey Psarellis | Contracted Managing Employee | May 1, 2021 | |
| Corporate Officer | May 1, 2021 | ||
| Operational/Managerial Control | May 1, 2021 | 20% | |
| Patricia M Prechter | Corporate Officer | May 1, 2021 | 25% |
| Corporate Director | May 1, 2021 | 25% | |
| W-2 Managing Employee | May 1, 2021 | 25% | |
| Commcare Corporation | 5% Or Greater Direct Ownership Interest | May 1, 2021 | 100% |
| Mary C Hudson | W-2 Managing Employee | May 1, 2020 | |
| Garold a Mangun | Corporate Officer | Jul 1, 2021 | 25% |
| Corporate Director | May 1, 2021 | 25% | |
| Commcare Management Corporation | Operational/Managerial Control | May 1, 2021 | 100% |
Owners & managing parties with NPI records 14
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba St. Anthony Community Care Center
- Skilled Nursing Facility
- Metairie, LA
- NPI 1588647564
5% Or Greater Direct Ownership Interest
-
dba Greenbriar Community Care Center
- Skilled Nursing Facility
- Slidell, LA
- NPI 1083650840
5% Or Greater Direct Ownership Interest
-
dba Calcasieu Community Care Center
- Skilled Nursing Facility
- Lake Charles, LA
- NPI 1114102738
5% Or Greater Direct Ownership Interest
-
dba Chateau de Notre Dame Community Care Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1215093943
5% Or Greater Direct Ownership Interest
-
dba Wynhoven Community Care Center
- Skilled Nursing Facility
- Marrero, LA
- NPI 1245231992
5% Or Greater Direct Ownership Interest
-
dba Ridgecrest Community Care Center
- Skilled Nursing Facility
- West Monroe, LA
- NPI 1316905870
5% Or Greater Direct Ownership Interest
-
dba Community Care Center of Baker
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1407813652
5% Or Greater Direct Ownership Interest
-
dba Old Brownlee Community Care Center
- Skilled Nursing Facility
- Bossier City, LA
- NPI 1518905983
5% Or Greater Direct Ownership Interest
-
dba Trinity Trace Community Care Center
- Skilled Nursing Facility
- Covington, LA
- NPI 1528000965
5% Or Greater Direct Ownership Interest
-
dba Heritage Manor Natchitoches Rehab & Retirement Center
- Skilled Nursing Facility
- Natchitoches, LA
- NPI 1588622286
5% Or Greater Direct Ownership Interest
-
dba Tioga Community Care Center
- Skilled Nursing Facility
- Pineville, LA
- NPI 1619935905
5% Or Greater Direct Ownership Interest
-
dba Baton Rouge Health Care Center
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1639136989
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 13
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Old Jefferson Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Natchitoches Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Tioga Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Riviere de Soleil Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Ridgecrest Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Greenbriar Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Baton Rouge Healthcare Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Guest House of Slidell | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 2008 |
| Old Brownlee Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Mar 1, 1994 |
| Calcasieu Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Sep 30, 2022 |
| Chateau de Notre Dame Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 14, 2023 |
| Chateau de Notre Dame Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 14, 2023 |
| Wynhoven Community Care Center | Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 14, 2023 |
Owned or controlled facilities with NPI records 13
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Greenbriar Community Care Center
- Skilled Nursing Facility
- Slidell, LA
- NPI 1083650840
5% Or Greater Direct Ownership Interest
-
dba Calcasieu Community Care Center
- Skilled Nursing Facility
- Lake Charles, LA
- NPI 1114102738
5% Or Greater Direct Ownership Interest
-
dba Chateau de Notre Dame Community Care Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1215093943
5% Or Greater Direct Ownership Interest
-
dba Wynhoven Community Care Center
- Skilled Nursing Facility
- Marrero, LA
- NPI 1245231992
5% Or Greater Direct Ownership Interest
-
dba Ridgecrest Community Care Center
- Skilled Nursing Facility
- West Monroe, LA
- NPI 1316905870
5% Or Greater Direct Ownership Interest
-
dba Community Care Center of Baker
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1407813652
5% Or Greater Direct Ownership Interest
-
dba Old Brownlee Community Care Center
- Skilled Nursing Facility
- Bossier City, LA
- NPI 1518905983
5% Or Greater Direct Ownership Interest
-
dba Trinity Trace Community Care Center
- Skilled Nursing Facility
- Covington, LA
- NPI 1528000965
5% Or Greater Direct Ownership Interest
-
dba Heritage Manor Natchitoches Rehab & Retirement Center
- Skilled Nursing Facility
- Natchitoches, LA
- NPI 1588622286
5% Or Greater Direct Ownership Interest
-
dba Tioga Community Care Center
- Skilled Nursing Facility
- Pineville, LA
- NPI 1619935905
5% Or Greater Direct Ownership Interest
-
dba Baton Rouge Health Care Center
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1639136989
5% Or Greater Direct Ownership Interest
-
dba Riviere de Soleil Community Care Center
- Skilled Nursing Facility
- Mansura, LA
- NPI 1780642074
5% Or Greater Direct Ownership Interest
Facilities with the same owner 17
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba The John J. Hainkel, Jr. Home and Rehabilitation Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1558906370
Commcare Management Corporation
-
dba St. Anthony Community Care Center
- Skilled Nursing Facility
- Metairie, LA
- NPI 1588647564
Commcare Management Corporation
-
dba Greenbriar Community Care Center
- Skilled Nursing Facility
- Slidell, LA
- NPI 1083650840
Commcare Corporation, Commcare Management Corporation
-
dba Calcasieu Community Care Center
- Skilled Nursing Facility
- Lake Charles, LA
- NPI 1114102738
Commcare Corporation, Commcare Management Corporation
-
dba Chateau de Notre Dame Community Care Center
- Skilled Nursing Facility
- New Orleans, LA
- NPI 1215093943
Commcare Corporation, Commcare Management Corporation
-
dba Wynhoven Community Care Center
- Skilled Nursing Facility
- Marrero, LA
- NPI 1245231992
Commcare Corporation, Commcare Management Corporation
-
dba Ridgecrest Community Care Center
- Skilled Nursing Facility
- West Monroe, LA
- NPI 1316905870
Commcare Corporation, Commcare Management Corporation
-
dba Community Care Center of Baker
- Skilled Nursing Facility
- Baton Rouge, LA
- NPI 1407813652
Commcare Corporation, Commcare Management Corporation
-
dba Old Brownlee Community Care Center
- Skilled Nursing Facility
- Bossier City, LA
- NPI 1518905983
Commcare Corporation, Commcare Management Corporation
-
dba Trinity Trace Community Care Center
- Skilled Nursing Facility
- Covington, LA
- NPI 1528000965
Commcare Corporation, Commcare Management Corporation
-
dba Heritage Manor Natchitoches Rehab & Retirement Center
- Skilled Nursing Facility
- Natchitoches, LA
- NPI 1588622286
Commcare Corporation, Commcare Management Corporation
-
dba Tioga Community Care Center
- Skilled Nursing Facility
- Pineville, LA
- NPI 1619935905
Commcare Corporation, Commcare Management Corporation
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Hammond, LA
- NPI 1497965198
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623196800000",
"number": "1710464664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 W CAUSEWAY APPROACH",
"city": "MANDEVILLE",
"state": "LA",
"postal_code": "704713082",
"telephone_number": "504-324-8950",
"fax_number": "985-624-3477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 HWY 51",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704541560",
"telephone_number": "985-229-2112",
"fax_number": "985-229-6992"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMCARE CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2018-07-24",
"last_updated": "2021-06-09",
"certification_date": "2021-06-09",
"status": "A",
"authorized_official_last_name": "PSARELLIS",
"authorized_official_first_name": "DAWN",
"authorized_official_middle_name": "HARVEY",
"authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
"authorized_official_telephone_number": "504-324-8950"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1515027",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Camelot Community Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Camelot Community Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Ponchatoula Community Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.