Primary Care Providers for a Healthy Feliciana Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Hammond, LA
NPI 1104704576 · NPPES record last updated Aug 25, 2025
Key facts
- NPI
- 1104704576
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA INC
- Practice address
- 2600 PFC Matthew E Wildes St
Hammond, LA 70403 - Phone
- (225) 683-5292
- Fax
- (225) 683-1310
- NPI assigned
- Aug 25, 2025
- Organization subpart
- No
Authorized official
- Name
- Christi C Hunt
- Title
- Ceo
- Phone
- (225) 683-5292
Owners & managing parties with NPI records 1
-
Darie S. Gilliam, FNP-C
Corporate family (same tax ID) 20
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Federally qualified health center certification: CCN 951064
- Legal name
- PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC
- Doing business as
- RKM AT HAMMOND WESTSIDE MONTESSORI
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 1, 2025
- Last certification
- Dec 1, 2025
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 2600 PFC Matthew E Wildes St
RM 703
Hammond, LA 70403
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Richard C Holton |
Other | Oct 25, 2007 | |
| Neil M Manuel |
Corporate Officer |
Mar 28, 2022 | 100% |
| Operational/Managerial Control |
Mar 28, 2022 | 100% | |
| Alfreda D Jackson |
Other | Sep 29, 2009 | |
| Darie S Gilliam |
Corporate Officer |
May 1, 2005 | 100% |
| Operational/Managerial Control |
May 1, 2005 | 100% | |
| Kenny Sanders |
Other | Sep 22, 2011 | |
| Matthew King |
Corporate Officer |
Feb 25, 2025 | 100% |
| Operational/Managerial Control |
Feb 25, 2025 | 100% | |
| Christy Bond |
Operational/Managerial Control |
Aug 28, 2023 | 100% |
| Other | Aug 28, 2023 | ||
| Christi C Hunt |
Corporate Officer |
Oct 20, 2020 | 100% |
| Operational/Managerial Control |
Oct 20, 2020 | 100% | |
| Virdie Moeller |
Other | Mar 28, 2013 | |
| Nicole C Wilcher |
Other | Mar 28, 2013 | |
| Wayne Birt |
Other | Aug 31, 2020 | |
| Columbus Hutchinson |
Other | Mar 29, 2018 | |
| Anita P Cambre |
Other | Oct 25, 2007 | |
| Mark Kemp |
Other | Mar 28, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251216002171 | LA | Part a Provider - Federally Qualified Health Center (FQHC) | 1052220985 | Practice locations: Hammond, LA |
National Provider Directory
- Tax ID family
- Primary Care Providers for a Healthy Feliciana Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
2600 PFC Matthew E Wildes St
Hammond, LA 70403
Mailing address
PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292
Other names
- Hammond Westside Montessori
Other providers in Hammond, LA
- Prescribed Pediatric Extended Care, Inc
- Kylah Renee Price
- Adele Prima
- Primary Care Providers for a Healthy Feliciana Inc
- Primary Care Providers for a Healthy Feliciana Inc
- Primary Care Providers for a Healthy Feliciana Inc
- Primary Care Providers for a Healthy Feliciana Inc
- Primary Care Providers for a Healthy Feliciana Inc
- Primary Care Providers for a Healthy Feliciana Inc
- Primary Care Providers for a Healthy Feliciana, Inc.
All providers in Hammond, LA · Federally Qualified Health Center (FQHC) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.