NPIMap

Organization Active NPI

Teche Action Board, Inc.

Doing business as Teche Action Clinic

  • Clinic/Center
  • Franklin, LA
National Provider Identifier
1821272949
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
04402470N Issued in LA
Legal business name
TECHE ACTION BOARD, INC.
Doing business as
Teche Action Clinic
Practice address
1115 Weber Street
Franklin, LA 70538-4124
Phone
(337) 828-2550
Fax
(337) 355-2335
NPI assigned
Dec 26, 2007
Last updated
Jul 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Dr. Gary M Wiltz, MDNPI 1477596351
Title
Ceo
Phone
(337) 828-2550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 04402470N LA Primary

Addresses

Primary practice location

1115 Weber Street
Franklin, LA 70538-4124

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1136174MedicaidLA

Other names 1

  • Teche Action Clinic Doing business as

Medicare participation

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

Enrollment records 1

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…

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

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 3

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": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1821272949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 WEBER STREET",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 WEBER STREET",
            "city": "FRANKLIN",
            "state": "LA",
            "postal_code": "705384124",
            "telephone_number": "337-828-2550",
            "fax_number": "337-355-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECHE ACTION BOARD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "WILTZ",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-828-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "LA",
            "license": "04402470N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1136174",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teche Action Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.