Organization Active NPI

Collaborative Health Nola, LLC

  • Nursing Care Agency
  • Kenner, LA
National Provider Identifier
1871241182
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
COLLABORATIVE HEALTH NOLA, LLC
Practice address
2401 Idaho Ave
Kenner, LA 70062-5715
Phone
(504) 466-0222
NPI assigned
Mar 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Nikesha Guice DuplessisNPI 1134551831
Title
Nurse Practitioner
Phone
(504) 345-6217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X Primary
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X
Assisted Living Facility 310400000X

Addresses

Primary practice location

2401 Idaho Ave
Kenner, LA 70062-5715

Mailing address

PO Box 295
Mandeville, LA 70470-0295
Phone (504) 345-6217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220421000055 LA Part B Supplier - Clinic/Group Practice 4981091964 Receives reassigned benefits from 1 practitioner
Practice locations: Kenner, LA

National Provider Directory

National Provider Directory

Locations

2401 Idaho Ave
#C
Kenner, LA 70062
Phone (504) 466-0222

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1871241182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704700295",
            "telephone_number": "504-345-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 IDAHO AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700625715",
            "telephone_number": "504-466-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE HEALTH NOLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "DUPLESSIS",
        "authorized_official_first_name": "NIKESHA",
        "authorized_official_middle_name": "GUICE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "504-345-6217"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.