Common Ground Health Clinic

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

261QF0400X Issued in LA

Legal business name

COMMON GROUND HEALTH CLINIC

Practice address

3737 General Degaulle Dr
New Orleans, LA 70114-8205

Phone

(504) 361-9800

NPI assigned

Apr 18, 2014

Last updated

Dec 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carleetha Lankster-Smith

Title

Ceo

Phone

(504) 361-9800

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801216767. Details of each certification follow.

• CCN 191932 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 191932

Legal name

COMMON GROUND HEALTH CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 8, 2015

Last certification

Apr 8, 2015

Ownership / control type

For profit – corporation

Facility address

3737 General Degaulle Dr
New Orleans, LA 70114

Locations

Practitioners 5

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.

• Robin R Fouquet, FNP-C

  • Primary Care Nurse Practitioner
  • New Orleans, LA
  • NPI 1114536703
  NPD (past)
• Jean Ann Mathis, M.D.

  • Obstetrics & Gynecology Physician
  • Marrero, LA
  • NPI 1336191378
  NPD (past)
• Mikshira Marie Mosely, FNP

  • Family Nurse Practitioner
  • New Orleans, LA
  • NPI 1780160606
  NPD (past)
• Marie Alexia Mussman, PA-C

  • Physician Assistant
  • Gretna, LA
  • NPI 1952071102
  NPD (past)
• Andre Dominick Tilton, MD

  • Family Medicine Physician
  • New Orleans, LA
  • NPI 1306165097
  NPD (past)

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1801216767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 WALL BLVD",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567723",
            "telephone_number": "504-361-9800",
            "fax_number": "504-368-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 GENERAL DEGAULLE DR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701148205",
            "telephone_number": "504-361-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMON GROUND HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-18",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "LANKSTER-SMITH",
        "authorized_official_first_name": "CARLEETHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-361-9800"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": "261QF0400X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2356241",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charlise.hope.1@17106.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "3737 General Degaulle Dr",
            "city": "New Orleans",
            "state": "LA",
            "country_code": "US",
            "postal_code": "701148205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sean Comiskey, LMSW
• Commcare Corporation (Chateau de Notre Dame Community Care Center)
• Commcare Corporation (Our Lady of Wisdom Community Care Center)
• Marius Marcel Commodore, MD
• Common Ground Health Clinic
• Common Ground Health Clinic
• Community Academies of New Orleans
• Community Academies of New Orleans
• Community Academies of New Orleans
• Community Care LLC

• Federally Qualified Health Center (FQHC) in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Federally Qualified Health Center (FQHC) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.