NPIMap

Organization Active NPI

Access Health Louisiana

Doing business as Grant Jr And High SBHC

  • Federally Qualified Health Center (FQHC)
  • Dry Prong, LA
National Provider Identifier
1821717935
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ACCESS HEALTH LOUISIANA
Doing business as
Grant Jr And High SBHC
Practice address
17763 Highway 167
Dry Prong, LA 71423-9205
Phone
(866) 530-6111
NPI assigned
Aug 23, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Mark Keiser
Title
Ceo
Phone
(504) 575-3700

Specialties & licenses 1

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

Addresses

Primary practice location

17763 Highway 167
Dry Prong, LA 71423-9205

Mailing address

2900 Indiana Ave
Kenner, LA 70065-4605
Phone (504) 575-3712

Other names 1

  • Grant Jr And High SBHC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230926002842 LA Part A Provider - Federally Qualified Health Center (FQHC) 3678484276 Practice locations: Dry Prong, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821717935. Details of each certification follow.

Federally qualified health center certification: CCN 191151

Legal name
ACCESS HEALTH LOUISIANA
Doing business as
GRANT JR & HIGH SBHC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 3, 2023
Last certification
Aug 3, 2023
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Mar 1, 2002 in LA
Enrollment address
17763 Highway 167
Dry Prong, LA 71423-9205

National Provider Directory

National Provider Directory
Tax ID family
St Charles Community Health Center Inc89 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

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

View all 18

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Peter Torsch Individual Corporate OfficerCfo Nov 19, 2015
Corporate DirectorCfo Nov 19, 2015
Mark Francis Keiser Individual Corporate OfficerCeo Mar 1, 2002
Corporate DirectorCeo Mar 1, 2002
W-2 Managing EmployeeCeo Mar 1, 2002
John Cressend Schonberg Individual Corporate OfficerVice Chairman of the Board Mar 1, 2002
Timothy J. Vial Individual Corporate OfficerChairman of the Board Mar 1, 2002

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
St James Alternative School SBHCVacherie, LA, CCN 191087 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Kenner Community Health CenterKenner, LA, CCN 191096 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Luling Elementary School SBHCLuling, LA, CCN 191100 Federally qualified health center Operational/Managerial Control Apr 1, 2003
Destrehan HS SBHCDestrehan, LA, CCN 191104 Federally qualified health center Operational/Managerial Control Apr 1, 2003

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1821717935",
    "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": "504-575-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17763 HIGHWAY 167",
            "city": "DRY PRONG",
            "state": "LA",
            "postal_code": "714239205",
            "telephone_number": "866-530-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS HEALTH LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "KEISER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-575-3700"
    },
    "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": "Grant Jr And High SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dry Prong, LA

Sources for this page

Verify at the official NPI Registry.