NPIMap

Organization Active NPI

Primary Care Providers for a Healthy Feliciana Inc

Doing business as Greenville Park Leadership Academy

  • Federally Qualified Health Center (FQHC)
  • Hammond, LA
National Provider Identifier
1265319784
Registry record updated Aug 18, 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
Greenville Park Leadership Academy
Practice address
111 J W Davis Dr
Hammond, LA 70403-3931
Phone
(225) 683-5292
Fax
(225) 683-1310
NPI assigned
Aug 18, 2025
Last updated
Aug 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 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 Primary

Addresses

Primary practice location

111 J W Davis Dr
Hammond, LA 70403-3931

Mailing address

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

Other names 1

  • Greenville Park Leadership Academy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260225002140 LA Part A Provider - Federally Qualified Health Center (FQHC) 1052220985 Practice locations: Hammond, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265319784. Details of each certification follow.

Federally qualified health center certification: CCN 951190

Legal name
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC
Doing business as
RKM AT GREENVILLE PARK LEADERSHIP ACADEMY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 20, 2025
Last certification
Oct 20, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
111 JW Davis Dr
RM Library
Hammond, LA 70403-3931

National Provider Directory

National Provider Directory
Tax ID family
RKM Primary72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

111 J W Davis Dr
Hammond, LA 70403

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
Richard C Holton Individual OtherBoard Member Oct 25, 2007
Neil M Manuel Individual Corporate OfficerCoo Mar 28, 2022
Alfreda D Jackson Individual OtherBoard Memeber Sep 29, 2009
Darie S Gilliam Individual Corporate OfficerCco May 1, 2005 100%
Kenny Sanders Individual OtherBoard Memeber Sep 22, 2011
Matthew King Individual Corporate OfficerCfo Feb 25, 2025 100%
Christy Bond Individual OtherRevenue System Manager Aug 28, 2023
Christi C Hunt Individual Corporate OfficerCeo Oct 20, 2020 100%
W-2 Managing Employee Oct 20, 2025
Virdie Moeller Individual OtherBoard Member Mar 28, 2013
Nicole C Wilcher Individual OtherBoard Memeber Mar 28, 2013
Wayne Birt Individual OtherBoard Memeber Aug 31, 2020
Columbus Hutchinson Individual OtherBoard Memeber Mar 29, 2018
Anita P Cambre Individual OtherBoard Memeber Oct 25, 2007
Mark Kemp Individual OtherBoard Memeber Mar 28, 2013
Shunda Spurlock-Haile Individual OtherBoard Memeber Jul 25, 2024

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": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1265319784",
    "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": "111 J W DAVIS DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704033931",
            "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": "2025-08-18",
        "last_updated": "2025-08-18",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Park Leadership Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.