NPIMap

Organization Active NPI

Primary Care Providers for a Healthy Feliciana, Inc

  • Federally Qualified Health Center (FQHC)
  • Port Allen, LA
National Provider Identifier
1770760902
Registry record updated Jan 28, 2021
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
Practice address
203 Allendale Dr
Port Allen, LA 70767-3219
Phone
(225) 389-1311
Fax
(225) 389-1330
NPI assigned
Jan 30, 2008
Organization subpart
Yes
Parent organization
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Ginger A. Hunt, CEO
Title
Ceo
Phone
(225) 683-5292

Specialties & licenses 1

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

Addresses

Primary practice location

203 Allendale Dr
Port Allen, LA 70767-3219

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 389-1311

Other identifiers 1

IdentifierTypeStateIssuer
1038814MedicaidLA

Other names 1

  • WBR Primary Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040224000173 LA Part B Supplier - Clinic/Group Practice 1052220985 Receives reassigned benefits from 99 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Springfield, LA; Slaughter, LA; Port Allen, LA; Jackson, LA; Loranger, LA; Clinton, LA; Baton Rouge, LA; Livingston, LA
O20080430000894 LA Part A Provider - Federally Qualified Health Center (FQHC) 1052220985 Practice locations: Port Allen, LA

Federally qualified health center certification: CCN 191860

Legal name
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC
Doing business as
WBR PRIMARY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 12, 2008
Last certification
May 12, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 6, 1998 in LA
Enrollment address
203 Allendale Dr
Port Allen, LA 70767-3219

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Providers for a Healthy Feliciana Inc71 organizations share this tax ID, including this one
Part of
Primary Care Providers for a Healthy Feliciana Inc

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

Ownership & related parties

All disclosed owners & managing parties 12

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 Corporate DirectorBoard Member Oct 25, 2007
Alfreda D Jackson Individual Corporate DirectorBoard Member Sep 29, 2009
Veronica D Easterly Individual Corporate DirectorBoard Member Sep 30, 2010
Kenny Sanders Individual Corporate DirectorBoard Member Sep 22, 2011
Christi C Hunt Individual Corporate OfficerCeo Oct 17, 2020
W-2 Managing EmployeeCeo Oct 17, 2020
Operational/Managerial ControlCeo Oct 17, 2020
Virdie Moeller Individual Corporate DirectorBoard Member Mar 28, 2013
Nicole C Wilcher Individual Corporate DirectorBoard Member Mar 28, 2013
Wayne Birt Individual Corporate DirectorBoard Member Aug 31, 2020
Louis J Kent Individual Corporate DirectorBoard Member Aug 6, 1998
Columbus Hutchinson Individual Corporate DirectorBoard Member Mar 29, 2018
Anita P Cambre Individual Corporate DirectorBoard Member Oct 25, 2007
Mark Kemp Individual Corporate DirectorBoard Member Mar 28, 2013

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1770760902",
    "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": "225-389-1311",
            "fax_number": "225-683-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 ALLENDALE DR",
            "city": "PORT ALLEN",
            "state": "LA",
            "postal_code": "707673219",
            "telephone_number": "225-389-1311",
            "fax_number": "225-389-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC.",
        "enumeration_date": "2008-01-30",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-683-5292",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038814",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WBR Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WBR Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Allen, LA

Sources for this page

Verify at the official NPI Registry.