SOUTHEAST COMMUNITY HEALTH SYSTEMS (NPI# 1558515676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558515676 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST COMMUNITY HEALTH SYSTEMS |
| Other Organization Name | SOUTHEAST COMMUNITY HEALTH SYSTEMS @ KENTWOOD |
| Practice Address |
721 Avenue G Kentwood LA 70444-2601 |
| Mailing Address |
Po Box 770 Zachary LA 70791-0770 |
| Practice Telephone | 9852295507 |
| Practice Fax Number | 9852296828 |
| Mailing Telephone | 2253062000 |
| Mailing Fax Number | 2256581282 |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2014-11-25 |
| Authorized Official Name | DR. ALECIA CYPRIAN (CEO) |
| Authorized Official Telephone | 2253062000 |
| Authorized Official Credential | PHD |
| 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 | 1806935 | 05 |
| Other Name | Type Code |
|---|---|
| Southeast Community Health Systems @ Kentwood | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376062513 | Southeast Community Health Systems | Clinic/Center | 43052 Yokum Rd, Hammond, LA 70403-6351 | 2017-09-19 |
| 1194277806 | Southeast Community Health Systems | Clinic/Center | 501 Erwin Neil Way Hammond, Hammond, LA 70403 | 2016-10-28 |
| 1487105102 | Southeast Community Health Systems | Clinic/Center | 15649 Highway 440, Kentwood, LA 70444-6939 | 2016-10-18 |
| 1558812255 | Southeast Community Health Systems | Clinic/Center | 15841 Highway 440, Kentwood, LA 70444-6937 | 2016-10-18 |
| 1467903187 | Southeast Community Health Systems | Clinic/Center | 68495 Highway 1054, Kentwood, LA 70444-6911 | 2016-10-18 |
| 1912458639 | Southeast Community Health Systems | Clinic/Center | 72961 Highway 1061, Kentwood, LA 70444-5833 | 2016-10-18 |
| 1013468909 | Southeast Community Health Systems | Clinic/Center | 603 9th St, Kentwood, LA 70444-2317 | 2016-10-17 |
| 1306397328 | Southeast Community Health Systems | Clinic/Center | 1459 Service Rd, Kentwood, LA 70444-3013 | 2016-10-14 |
| 1649628397 | Southeast Community Health Systems | Clinic/Center | 77 Greensburg Street, Greensburg, LA 70441 | 2016-06-02 |
| 1053769794 | Southeast Community Health Systems | Clinic/Center | 25753 Walker Road South, Denham Springs, LA 70726 | 2016-06-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTHEAST COMMUNITY HEALTH SYSTEMS | 6351 Main St, Zachary, LA 70791-4038 |
| Street Address |
721 AVENUE G |
| City | KENTWOOD |
| State | LA |
| Zip Code | 70444-2601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376587014 | Jennifer St. Romain | Nurse Practitioner | 721 Avenue G, Kentwood, LA 70444-2601 | 2006-06-15 |
| 1083176374 | Kizzy Woods | Nurse Practitioner | 721 Avenue G, Kentwood, LA 70444-2601 | 2019-04-04 |
| 1639692627 | Melody Denise Jones | Nurse Practitioner | 721 Avenue G, Kentwood, LA 70444-2601 | 2017-07-20 |
| 1245788587 | Geneva Carter | Nurse Practitioner | 721 Avenue G, Kentwood, LA 70444-2601 | 2016-09-15 |
| 1093107310 | Nikita Pearl | Nurse Practitioner | 721 Avenue G, Kentwood, LA 70444-2601 | 2015-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437703733 | Bridge Builders Consultants, LLC | In Home Supportive Care | Bridge Builders Consultants, LLC, 505 Avenue F, Ste A, Kentwood, LA 70444 | 2019-07-25 |
| 1336577576 | Penny Scardulla | Pharmacist | 717 Ave. G, Kentwood, LA 70444 | 2013-10-25 |
| 1891034716 | Freds Stores of Tennessee Inc | Pharmacy | 734 Avenue G # 38, Kentwood, LA 70444 | 2013-02-13 |
| 1407177348 | Bryan D. Tate Jr. | Nurse Practitioner | 919 Avenue G, Kentwood, LA 70444 | 2010-06-15 |
| 1174737720 | Harmony Center, Inc. | Intermediate Care Facility, Mental Illness | 1551 Cb Temple Sr. Road, Kentwood, LA 70444 | 2007-05-10 |
| 1780050294 | Kentwood Family Clinic LLC | Nurse Practitioner | 919 Avenue G, Kentwood, LA 70444 | 2015-08-19 |
| 1467670349 | Daryl Marshall Westmoreland Sr. | Dentist | 68144 Highway 51, 68144 Highway 51, Kentwood, LA 70444-0432 | 2007-04-23 |
| 1962989053 | Lets Keep It Moving Transportation | Non-emergency Medical Transport (VAN) | 412 7th St, Kentwood, LA 70444-2308 | 2018-07-23 |
| 1174009351 | Tamika Dickerson | Driver | 412 7th St, Kentwood, LA 70444-2308 | 2018-07-11 |
| 1013468909 | Southeast Community Health Systems | Clinic/Center | 603 9th St, Kentwood, LA 70444-2317 | 2016-10-17 |
| Find all providers in zip 70444 | ||||
| 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 |
|---|---|---|---|---|
| 1487105102 | Southeast Community Health Systems | Clinic/Center | 15649 Highway 440, Kentwood, LA 70444-6939 | 2016-10-18 |
| 1558812255 | Southeast Community Health Systems | Clinic/Center | 15841 Highway 440, Kentwood, LA 70444-6937 | 2016-10-18 |
| 1467903187 | Southeast Community Health Systems | Clinic/Center | 68495 Highway 1054, Kentwood, LA 70444-6911 | 2016-10-18 |
| 1912458639 | Southeast Community Health Systems | Clinic/Center | 72961 Highway 1061, Kentwood, LA 70444-5833 | 2016-10-18 |
| 1013468909 | Southeast Community Health Systems | Clinic/Center | 603 9th St, Kentwood, LA 70444-2317 | 2016-10-17 |
| 1306397328 | Southeast Community Health Systems | Clinic/Center | 1459 Service Rd, Kentwood, LA 70444-3013 | 2016-10-14 |
| 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 | ||||
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| 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.