Access Health Louisiana

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ACCESS HEALTH LOUISIANA

Practice address

2900 Indiana Ave
Kenner, LA 70065-4605

Phone

(504) 575-3712

Fax

(504) 575-3691

NPI assigned

Jul 18, 2015

Organization subpart

No

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

Authorized official

Name

Mark Keiser

Title

President

Phone

(504) 575-3700

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Access Health Louisiana Kenner Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Federally qualified health center certification: CCN 191016

Legal name

ACCESS HEALTH LOUISIANA

Doing business as

ACCESS HEALTH LA KENNER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 7, 2016

Last certification

Jun 7, 2016

Ownership / control type

For profit – corporation

Organization structure

OtherNon-profit

Incorporated

Mar 15, 2002 in LA

Enrollment address

2900 Indiana Avenue
Kenner, LA 70065-4605

All disclosed owners & managing parties 11

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

All facility ownership & control disclosures 4

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

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1821472879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654605",
            "telephone_number": "504-575-3700",
            "fax_number": "504-575-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 INDIANA AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654605",
            "telephone_number": "504-575-3712",
            "fax_number": "504-575-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-575-3700"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "LA",
            "license": "MD.206029",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2397729",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access Health Louisiana Kenner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Access Health Louisiana
• Access Health Louisiana
• Access Health Louisiana
• Access Health Louisiana
• Access Health Louisiana
• Access Health Louisiana
• Access Health Louisiana
• Advanced Medical Equipment, Inc.
• Mariam J Ahmed, M.D.
• Saeed Ahmed, M.D.

• All providers in Kenner, LA
• Federally Qualified Health Center (FQHC) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2016; 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.