NPIMap

Organization Active NPI

Primary Care Providers for a Healthy Feliciana Inc

Doing business as Ponchatoula High School

  • Federally Qualified Health Center (FQHC)
  • Ponchatoula, LA
National Provider Identifier
1093693277
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA INC
Doing business as
Ponchatoula High School
Practice address
19452 La 22
Ponchatoula, LA 70454
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Aug 25, 2025
Last updated
Aug 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Authorized official

Name
Christi C Hunt
Title
Ceo
Phone
(225) 683-5292

Specialties & licenses 1

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

Addresses

Primary practice location

19452 La 22
Ponchatoula, LA 70454

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Other names 1

  • Ponchatoula High School Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260104000063 LA Part A Provider - Federally Qualified Health Center (FQHC) 1052220985 Practice locations: Ponchatoula, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093693277. Details of each certification follow.

Federally qualified health center certification: CCN 951071

Legal name
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC
Doing business as
RKM AT PONCHATOULA HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 5, 2025
Last certification
Dec 5, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
19452 La 22
RM 314
Ponchatoula, LA 70454

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Providers for a Healthy Feliciana Inc72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

19452 Highway 22
Ponchatoula, LA 70454

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Richard C Holton Individual Other Oct 25, 2007
Neil M Manuel Individual Corporate OfficerCoo Mar 28, 2022 100%
Operational/Managerial ControlCoo Mar 28, 2022 100%
Alfreda D Jackson Individual Other Sep 29, 2009
Darie S Gilliam Individual Corporate OfficerCco) May 1, 2005 100%
Operational/Managerial ControlCco May 1, 2005 100%
Kenny Sanders Individual Other Sep 22, 2011
Matthew King Individual Corporate OfficerCfo Feb 25, 2025 100%
Operational/Managerial ControlCfo Feb 25, 2025 100%
Christy Bond Individual Operational/Managerial ControlRevenue System Manager Aug 28, 2023 100%
Other Aug 28, 2023
Christi C Hunt Individual Corporate OfficerCeo Oct 20, 2020 100%
Operational/Managerial ControlCeo Oct 20, 2020 100%
Virdie Moeller Individual Other Mar 28, 2013
Nicole C Wilcher Individual Other Mar 28, 2013
Wayne Birt Individual Other Aug 31, 2020
Columbus Hutchinson Individual Other Mar 29, 2018
Anita P Cambre Individual Other Oct 25, 2007
Mark Kemp Individual Other Mar 28, 2013

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1093693277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19452 LA 22",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "70454",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-683-5292"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ponchatoula High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ponchatoula, LA

Sources for this page

Verify at the official NPI Registry.