NPIMap

Organization Active NPI

Priority Health Care

  • Federally Qualified Health Center (FQHC)
  • Gretna, LA
National Provider Identifier
1841522711
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIORITY HEALTH CARE
Practice address
12 Westbank Expy
Gretna, LA 70053-3647
Phone
(504) 509-4800
Fax
(504) 509-4802
NPI assigned
Feb 3, 2010
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Mrs. Tamara Boutte Dioubate, MSW, MSHCM
Title
Ceo
Phone
(504) 309-6522

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Federally Qualified Health Center (FQHC) 261QF0400X LA Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

12 Westbank Expy
Gretna, LA 70053-3647

Mailing address

4700 Wichers Dr Ste 306
Marrero, LA 70072-3054
Phone (504) 309-6057

Other practice location 1

12A Westbank Expy Ste 111-112
Gretna, LA 70053-3659
Phone (504) 509-4800

Other identifiers 1

IdentifierTypeStateIssuer
2407597MedicaidLA

Other names 1

  • Gretna Site Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131205000208 LA Part B Supplier - Clinic/Group Practice 5395972988 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gretna, LA; Marrero, LA
O20160518000591 LA Part A Provider - Federally Qualified Health Center (FQHC) 5395972988 Practice locations: Gretna, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841522711. Details of each certification follow.

Federally qualified health center certification: CCN 191952

Legal name
PRIORITY HEALTH CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 2, 2016
Last certification
May 2, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 2009 in LA
Enrollment address
12 Westbank Expy
Gretna, LA 70053-3647

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Priority Health Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

12A Westbank Expy
Ste 111112
Gretna, LA 70053
Phone (504) 509-4800

4700 Wichers Dr
Ste 306
Marrero, LA 70072
Phone (504) 309-3262

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Tyra Trenise Brown Individual Corporate DirectorGoverning Board Chair Aug 25, 2009
Monique Williams- Johnson Individual Corporate DirectorGoverning Board Member Aug 20, 2020
Tamara B Dioubate Individual 5% Or Greater Direct Ownership InterestChief Executive Officer Aug 25, 2009 100%
W-2 Managing EmployeeChief Executive Officer Aug 25, 2009
Hiram Mitchell Walker Individual Corporate DirectorGoverning Board Member Aug 20, 2020
Daniel Lewis Individual Corporate DirectorGoverning Board Treasurer Sep 1, 2017
Larrion Dean Individual Corporate DirectorGoverning Board Member Sep 1, 2018
Fabian Ancar Individual Corporate DirectorGoverning Board Member May 1, 2019
Mervin Douglas Individual Corporate DirectorGoverning Board Member Jan 1, 2016
Arisa Banks Individual Corporate DirectorGoverning Board Secretary Dec 1, 2016
Cynthia Simmons Individual Corporate DirectorGoverning Board Parliamentarian Oct 1, 2018

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1841522711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WICHERS DR STE 306",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723054",
            "telephone_number": "504-309-6057",
            "fax_number": "504-309-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WESTBANK EXPY",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700533647",
            "telephone_number": "504-509-4800",
            "fax_number": "504-509-4802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12A Westbank Expy Ste 111-112",
            "address_purpose": "LOCATION",
            "city": "Gretna",
            "state": "LA",
            "postal_code": "700533659",
            "country_code": "US",
            "telephone_number": "504-509-4800",
            "fax_number": "504-509-4802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIORITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2025-09-02",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "DIOUBATE",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "BOUTTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-309-6522",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, MSHCM"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2407597",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gretna Site",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.