NPIMap

Organization Active NPI

Teche Action Board Inc

  • Federally Qualified Health Center (FQHC)
  • Pierre Part, LA
National Provider Identifier
1972746964
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TECHE ACTION BOARD INC
Practice address
3528 Highway 70 S
Pierre Part, LA 70339-4452
Phone
(985) 252-6211
Fax
(985) 252-0006
NPI assigned
Apr 7, 2009
Organization subpart
Yes
Parent organization
TECHE ACTION BOARD, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3528 Highway 70 S
Pierre Part, LA 70339-4452

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
5B803OtherLAMEDICARE PART B
1921572MedicaidLA

Other names 1

  • Teche Health @ Pierre Part Doing business as

Medicare participation

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

Enrollment records 2

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…
O20100127000221 LA Part A Provider - Federally Qualified Health Center (FQHC) 0648163980 Practice locations: Pierre Part, LA

Federally qualified health center certification: CCN 191875

Legal name
TECHE ACTION BOARD INC
Doing business as
TECHE HEALTH @ PIERRE PART
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 27, 2010
Last certification
Jan 27, 2010
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Enrollment address
3528 Highway 70 S
Pierre Part, LA 70339-4452
Related CCNs
191801

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

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

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 Clinic15 organizations share this tax ID, including this one
Part of
Teche Action Clinic

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Willie Rack Individual Corporate DirectorBoard Member Nov 3, 2014
Howard Castay Individual Corporate Director Nov 30, 2009
Berryl Broussard Individual W-2 Managing EmployeeChief Legal Officier May 3, 2021
Thomas Dardar Individual Corporate Director Nov 30, 2009
Barbara Hills Individual Corporate Director Nov 30, 2009
Eugene Dial Individual Corporate DirectorBoard Member Jan 3, 2022
Leroy Willis Individual Corporate Director Nov 30, 2009
Edna Lyons Individual Corporate Director Nov 30, 2009
Darrell Jupiter Individual Corporate DirectorBoard Member Dec 17, 2014
Denise Pitts Individual Corporate DirectorBoard Member Dec 5, 2011
Nikina Vilcan Individual W-2 Managing EmployeeCfo Aug 3, 2020
Rose Dorsey Individual Corporate Director Nov 30, 2009
Gary M Wiltz Individual Corporate OfficerCeo Nov 30, 2009 100%
W-2 Managing EmployeeCeo Nov 30, 2009 100%
Donnie Frizzell Individual Corporate Director Nov 30, 2009
Athan J Olivier Individual W-2 Managing EmployeeCoo Apr 22, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754870400000",
    "number": "1972746964",
    "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",
            "fax_number": "337-355-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 HIGHWAY 70 S",
            "city": "PIERRE PART",
            "state": "LA",
            "postal_code": "703394452",
            "telephone_number": "985-252-6211",
            "fax_number": "985-252-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECHE ACTION BOARD INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TECHE ACTION BOARD, INC.",
        "enumeration_date": "2009-04-07",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "5B803",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1921572",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teche Health @ Pierre Part",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pierre Part, LA

Sources for this page

Verify at the official NPI Registry.