NPIMap

Organization Active NPI

Concordia Parish Hospital Service District Number One

Doing business as Trinity Medical Ferriday Clinic

  • Rural Health Clinic/Center
  • Ferriday, LA
National Provider Identifier
1679513600
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Doing business as
Trinity Medical Ferriday Clinic
Practice address
204 Serio Blvd
Ferriday, LA 71334-2015
Phone
(318) 757-8010
Fax
(318) 757-9501
NPI assigned
Jun 7, 2006
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Nekeisha Lashay Smith
Title
Administrator
Phone
(318) 719-3636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 247A LA
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

204 Serio Blvd
Ferriday, LA 71334-2015

Mailing address

204 Serio Blvd
Ferriday, LA 71334
Phone (318) 757-0210

Other names 1

  • TRINITY MEDICAL FERRIDAY CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040216001076 LA Part B Supplier - Clinic/Group Practice 4587559935 Receives reassigned benefits from 7 practitioners
Practice locations: Ferriday, LA
O20180823000208 LA Part A Provider - Rural Health Clinic 4587559935 Practice locations: Ferriday, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679513600. Details of each certification follow.

Rural health clinic certification: CCN 198514

Legal name
CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Doing business as
TRINITY MEDICAL FERRIDAY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 14, 2019
Last certification
Aug 14, 2025
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
204 Serio Blvd
Ferriday, LA 71334-2015
Related CCNs
191318

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1004138Trinity Medical Ferriday Clinic204 Serio Boulevard, Ferriday, LA 71334Certificate of waiverSep 18, 2026

National Provider Directory

National Provider Directory
Tax ID family
Newellton Clinic5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Concordia Parish Hospital Service District Number One Organization, Ferriday, LA Non-profit 5% Or Greater Direct Ownership Interest May 1, 2015 100%
Operational/Managerial Control May 1, 2015 100%
Connie Vigil Individual Corporate Director Aug 12, 2019
Spencer Holder Individual Corporate OfficerCfo Aug 10, 2016
Operational/Managerial Control Feb 5, 2021
Nekeisha Smith Individual Corporate OfficerCeo Feb 5, 2021
W-2 Managing Employee Feb 5, 2021
Operational/Managerial ControlCeo Feb 5, 2021

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Trinity MedicalFerriday, LA, CCN 191318 Hospital Operational/Managerial Control Jun 1, 1966
Trinity MedicalFerriday, LA, CCN 19Z318 Hospital 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control		 Nov 1, 2004
Nov 1, 2004
Trinity Medical Vidalia ClinicVidalia, LA, CCN 198502 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 12, 2021
Jan 12, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 62

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1679513600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 SERIO BLVD",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "71334",
            "telephone_number": "318-757-0210",
            "fax_number": "318-757-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 SERIO BLVD",
            "city": "FERRIDAY",
            "state": "LA",
            "postal_code": "713342015",
            "telephone_number": "318-757-8010",
            "fax_number": "318-757-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NEKEISHA",
        "authorized_official_middle_name": "LASHAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-719-3636"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "247A",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRINITY MEDICAL FERRIDAY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRINITY MEDICAL FERRIDAY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ferriday, LA

Sources for this page

Verify at the official NPI Registry.