NPIMap

Organization Active NPI

Marillac Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
National Provider Identifier
1740949155
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARILLAC COMMUNITY HEALTH CENTERS
Practice address
1523 St. Charles Avenue
New Orleans, LA 70130
Phone
(504) 207-3060
NPI assigned
Dec 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Authorized official

Name
Michael Griffin
Title
President/Ceo
Phone
(504) 207-3060

Specialties & licenses 1

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

Addresses

Primary practice location

1523 St. Charles Avenue
New Orleans, LA 70130

Mailing address

PO Box 13038
New Orleans, LA 70185-3038
Phone (504) 207-3060

Other names 1

  • DePaul Community Health Centers-St. Charles Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110314000767 LA Part B Supplier - Clinic/Group Practice 3678755535 Receives reassigned benefits from 128 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kenner, LA; New Orleans, LA; Metairie, LA; Harvey, LA
O20240611000274 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678755535 Practice locations: New Orleans, LA

Federally qualified health center certification: CCN 191184

Legal name
MARILLAC COMMUNITY HEALTH CENTERS
Doing business as
DEPAUL COMMUNITY HEALTH CENTERS-ST. CHARLES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 5, 2024
Last certification
Apr 5, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 14, 2010 in LA
Enrollment address
1523 Saint Charles Ave
New Orleans, LA 70130-4445

Other NPIs on the same Medicare enrollment 21

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

View all 21

National Provider Directory

National Provider Directory
Tax ID family
Marillac Comm HLTH Centers69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

5646 Read Blvd
Ste 380
New Orleans, LA 70127
Phone (504) 518-5822

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ellen Kron Individual Corporate DirectorBoard Member Oct 26, 2010
Wendy Rios-Wood Individual W-2 Managing EmployeeCredentialing Specialist Mar 30, 2026
Roderic Teamer Individual Corporate DirectorBoard Chair Oct 26, 2010
Stephanie Navarre Individual Corporate DirectorVice Chair Oct 26, 2010
Michael Griffin Individual W-2 Managing EmployeeCeo Jul 27, 2001
Robert Angelico Individual Corporate DirectorBoard Member Oct 26, 2010

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Depaul Community Health CentersNew Orleans, LA, CCN 191974 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jul 15, 2010

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1740949155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13038",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701853038",
            "telephone_number": "504-207-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 ST. CHARLES AVENUE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70130",
            "telephone_number": "504-207-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILLAC COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2022-11-22",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "504-207-3060"
    },
    "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": "DePaul Community Health Centers-St. Charles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DePaul Community Health Centers-St. Charles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.