NPIMap

Primary Care Providers for a Healthy Feliciana, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Clinton, LA

NPI 1821245127 · NPPES record last updated Jan 28, 2021

Key facts

NPI
1821245127
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
10701 Reiley Street
Clinton, LA 70722-3210
Phone
(225) 683-1350
Fax
(225) 683-1359
NPI assigned
Aug 19, 2008
Organization subpart
Yes
Parent organization (as reported)
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC

Authorized official

Name
Ginger A Hunt, FPNP-C
Title
Ceo
Phone
(225) 683-5292

Other NPIs on the same Medicare enrollment 11

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

Corporate family (same tax ID) 24

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

Practitioners 103

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

View all 103

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA, MS

Federally qualified health center certification: CCN 191872

Legal name
PRIMARY CARE PROVIDERS FOR A HEALTHY FELICIANA, INC
Doing business as
CLINTON LOWER HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 13, 2009
Last certification
Oct 13, 2009
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 6, 1998 in LA
Enrollment address
10701 Reiley St
Clinton, LA 70722-0395

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

Medicare enrollment records

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
Practice locations: Springfield, LA; Slaughter, LA; Port Allen, LA; Jackson, LA; Loranger, LA; Clinton, LA; Baton Rouge, LA; Livingston, LA
O20091008000676 MS Part a Provider - Federally Qualified Health Center (FQHC) 1052220985 Practice locations: Clinton, LA

National Provider Directory

Tax ID family
Primary Care Providers for a Healthy Feliciana Inc (71 organizations share this tax ID)
Part of
Primary Care Providers for a Healthy Feliciana Inc

Locations

54016 Highway 1062
Loranger, LA 70446
Phone (985) 606-9000

Specialties & licenses

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

Addresses

Primary practice location

10701 Reiley Street
Clinton, LA 70722-3210

Mailing address

P.O. Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Other identifiers

IdentifierTypeStateIssuer
1188522MedicaidLA

Other names

  • Clinton Lower Health Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 28, 2021.

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1821245127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 395",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707220395",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 REILEY STREET",
            "city": "CLINTON",
            "state": "LA",
            "postal_code": "707223210",
            "telephone_number": "225-683-1350",
            "fax_number": "225-683-1359"
        }
    ],
    "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": "2008-08-19",
        "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": "FPNP-C"
    },
    "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": "1188522",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinton Lower Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinton Lower Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, LA

All providers in Clinton, LA · Federally Qualified Health Center (FQHC) in Louisiana

Sources for this page

Verify at the official NPI Registry.