JEFFERSON COMMUNITY HEALTH CARE CENTERS (NPI# 1154621290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154621290 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COMMUNITY HEALTH CARE CENTERS |
| Practice Address |
11312 Jefferson Hwy River Ridge LA 70123-1709 |
| Mailing Address |
1855 Ames Blvd Marrero LA 70072-3429 |
| Practice Telephone | 5043280488 |
| Practice Fax Number | 5043280899 |
| Mailing Telephone | 5043280488 |
| Mailing Fax Number | 5043280899 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-11-17 |
| Authorized Official Name | MR. RANDOLPH J FISHER (INTERIM CEO) |
| Authorized Official Telephone | 5043280488 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1649406497 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952601684 | Jefferson Community Health Care Centers | Clinic/Center | 108 Willow Lane, Grand Isle, LA 70358 | 2010-10-28 |
| 1144520677 | Jefferson Community Health Care Centers | Clinic/Center | 1855 Ames Blvd, Marrero, LA 70072-3429 | 2010-11-01 |
| 1063712107 | Jefferson Community Health Care Centers | Clinic/Center | 4028 Highway 90 W, Avondale, LA 70094-2622 | 2010-10-22 |
| Street Address |
11312 JEFFERSON HWY |
| City | RIVER RIDGE |
| State | LA |
| Zip Code | 70123-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366427460 | Renetta Walters Allen | Nurse Practitioner | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2005-12-12 |
| 1174664510 | East Jefferson Community Health Center | Clinic/Center | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2007-02-09 |
| 1891831376 | Jefferson Community Health Care Centers Inc | Family Medicine | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2007-01-30 |
| 1912050832 | Phyllis Renee Jackson-williams | Dentist | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2007-01-22 |
| 1366421562 | Mario Kakazu | Emergency Medicine | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2006-01-16 |
| 1477532885 | Keith William Blackman | Preventive Medicine | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2006-01-13 |
| 1902884158 | Maritza Elizabeth Salgado | Nurse Practitioner | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2006-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437780327 | Cerner Health Connections, Inc | Pharmacy | The Laitram Pharmacy, 5307 Toler St, Harahan, LA 70123 | 2020-01-29 |
| 1184111270 | Option Care Enterprises, Inc. | Pharmacy | 524 Elmwood Park Blvd Ste 120, Elmwood, LA 70123 | 2018-04-16 |
| 1740703214 | Rebekah Murray Dykes | Physician Assistant | 9605 Jefferson Hwy Ste G, River Ridge, LA 70123 | 2017-07-17 |
| 1710420260 | Cindy M Tregre | Counselor | 1529 River Oaks Rd W Ste 121, New Orleans, LA 70123 | 2016-11-30 |
| 1184098725 | Tiffany Marie Banye | Case Manager/Care Coordinator | 5341 Citrus Blvd Apt L272, River Ridge, LA 70123 | 2015-11-19 |
| 1003290123 | Phoebe Rae Plaisance | Student in an Organized Health Care Education/Training Program | 1336 Hickory Ave., Apt. C, Harahan, LA 70123 | 2015-07-18 |
| 1255711495 | Chris Dysart | Physical Therapist | 1827 Hickory Ave Ste B, Harahan, LA 70123 | 2015-06-03 |
| 1184043275 | Joanna Cross-call Buckingham | Pediatrics | 9605 Jefferson Highway, River Ridge, LA 70123 | 2014-04-16 |
| 1972927259 | Cassandra Williams | Chiropractor | 844 S Clearview Pkwy Apt 209, River Ridge, LA 70123 | 2014-02-07 |
| 1770906182 | Amber Bloom | Chiropractor | 9045 Jefferson Highway, River Ridge, LA 70123 | 2014-01-22 |
| Find all providers in zip 70123 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649406497 | Jefferson Community Health Care Centers, Inc. | Clinic/Center | 11312 Jefferson Highway, River Ridge, LA 70123-1709 | 2009-06-08 |
| 1174664510 | East Jefferson Community Health Center | Clinic/Center | 11312 Jefferson Hwy, River Ridge, LA 70123-1709 | 2007-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073120614 | Marillac Community Health Centers | Clinic/Center | 721 Saint Philip St, New Orleans, LA 70116-2713 | 2020-09-28 |
| 1699382697 | Start Corporation | Clinic/Center | 106 School Street, Houma, LA 70360 | 2020-09-24 |
| 1801402433 | Hiv/aids Alliance for Region Two, Inc. | Clinic/Center | 30789 N Range Avenue, Denham Springs, LA 70726 | 2020-09-18 |
| 1184239642 | Access Health Louisiana | Clinic/Center | 1400 Huey P Long Ave, Gretna, LA 70053-6436 | 2020-09-11 |
| 1770198681 | Marillac Community Health Centers | Clinic/Center | 4000 Cadillac St, New Orleans, LA 70122-1117 | 2020-09-09 |
| 1528673308 | Marillac Community Health Centers | Clinic/Center | 5800 Saint Roch Ave, New Orleans, LA 70122-5336 | 2020-09-09 |
| 1013522879 | Marillac Community Health Centers | Clinic/Center | 1423 Saint Philip St, New Orleans, LA 70116-2933 | 2020-09-09 |
| 1669086690 | Marillac Community Health Centers | Clinic/Center | 1908 Short St, Kenner, LA 70062-7550 | 2020-09-08 |
| 1023629425 | Winn Community Health Center, Inc. | Clinic/Center | 2200 N Bolton Ave, Alexandria, LA 71303-4407 | 2020-08-11 |
| 1467061515 | Council for Advancement of Social Service and Education | Clinic/Center | 1560 Irving Place, Shreveport, LA 71101-4604 | 2020-07-24 |
| Find all providers with the same taxonomy | ||||
| City | RIVER RIDGE |
| Zip Code | 70123 |
Please comment or provide details below to improve the information on JEFFERSON COMMUNITY HEALTH CARE CENTERS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.