NPIMap

Organization Active NPI

Fleur de Lis Family Healthcare of Cankton

  • Rural Health Clinic/Center
  • Cankton, LA
National Provider Identifier
1821630880
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FLEUR DE LIS FAMILY HEALTHCARE OF CANKTON
Practice address
376 Main St
Cankton, LA 70584-5920
Phone
(337) 668-4141
Fax
(337) 668-4386
NPI assigned
Oct 11, 2019
Last updated
Jul 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Michelle SonnierNPI 1427350446
Title
Owner
Phone
(337) 668-4141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

376 Main St
Cankton, LA 70584-5920

Mailing address

376 Main St
Cankton, LA 70584-5920
Phone (337) 668-4141

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fleur4@centurytel.net Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191028002582 LA Part A Provider - Rural Health Clinic 8325370109 Practice locations: Cankton, LA
O20220418000020 LA Part B Supplier - Clinic/Group Practice 8325370109 Receives reassigned benefits from 4 practitioners
Practice locations: Cankton, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821630880. Details of each certification follow.

Rural health clinic certification: CCN 193862

Legal name
FLEUR DE LIS FAMILY HEALTHCARE OF CANKTON
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 14, 2005
Last certification
Nov 2, 2023
Ownership / control type
1A
Most recent change of ownership
Mar 28, 2020 (1 total)
Organization structure
LLCProprietary
Incorporated
Mar 28, 2020 in LA
Enrollment address
376 Main St
Cankton, LA 70584-5920

National Provider Directory

National Provider Directory

Locations

376 Main St
Sunset, LA 70584
Phone (337) 668-4141

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Matthew Sonnier Individual 5% Or Greater Direct Ownership InterestOwner Mar 28, 2020 50%
General Partnership InterestOwner Mar 28, 2020 50%
Corporate OfficerOwner Mar 28, 2020 50%
Operational/Managerial ControlOwner Mar 28, 2020 50%
Michelle Claire Sonnier Individual 5% Or Greater Direct Ownership InterestOwner Mar 28, 2020 50%
General Partnership InterestOwner Mar 28, 2020 50%
Corporate OfficerOwner Mar 28, 2020 50%
Operational/Managerial ControlOwner Mar 28, 2020 50%

Owners & managing parties with NPI records 1

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

  • Michelle McNeal Sonnier, FNP
    • Family Nurse Practitioner
    • Cankton, LA
    • NPI 1427350446

    5% Or Greater Direct Ownership Interest, Corporate Officer, General Partnership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1821630880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 MAIN ST",
            "city": "CANKTON",
            "state": "LA",
            "postal_code": "705845920",
            "telephone_number": "337-668-4141",
            "fax_number": "337-668-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 MAIN ST",
            "city": "CANKTON",
            "state": "LA",
            "postal_code": "705845920",
            "telephone_number": "337-668-4141",
            "fax_number": "337-668-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEUR DE LIS FAMILY HEALTHCARE OF CANKTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-11",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "SONNIER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-668-4141"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fleur4@centurytel.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "376 Main St",
            "city": "Cankton",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705845920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cankton, LA

Sources for this page

Verify at the official NPI Registry.