NPIMap

Organization Active NPI

Alliance Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, IN
National Provider Identifier
1013880913
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALLIANCE HEALTH CENTERS INC.
Practice address
2620 S Western Ave
Marion, IN 46953-3556
Phone
(260) 266-0780
Fax
(260) 266-0785
NPI assigned
Sep 26, 2025
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Authorized official

Name
Autumn King
Title
Ceo
Phone
(260) 266-0780

Specialties & licenses 1

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

Addresses

Primary practice location

2620 S Western Ave
Marion, IN 46953-3556

Mailing address

2700 Lafayette St Ste 110
Fort Wayne, IN 46806-1100
Phone (260) 266-0780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201006002848 IN Part B Supplier - Clinic/Group Practice 8022437318 Receives reassigned benefits from 54 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Wayne, IN; Marion, IN; Auburn, IN
O20251027000622 IN Part A Provider - Federally Qualified Health Center (FQHC) 8022437318 Practice locations: Marion, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013880913. Details of each certification follow.

Federally qualified health center certification: CCN C51112

Legal name
ALLIANCE HEALTH CENTERS INC
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
2620 S Western Ave
Marion, IN 46953-3556

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Alliance Health Centers Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2700 Lafayette St
Ste 50
Fort Wayne, IN 46806

404 E Washington Blvd
Fort Wayne, IN 46802

5920 Decatur Rd
Ste 1
Fort Wayne, IN 46816

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
Fernando Zapari Individual Corporate Officer Sep 26, 2025
Bret W Claghorn Individual Corporate Officer Sep 26, 2025
Connie Heflin Individual Corporate Officer Sep 26, 2025
Melissa Grossman Individual Corporate Officer Sep 26, 2025
Philip Giaquinta Individual Corporate Officer Sep 26, 2025
Joseph Jordan Individual Corporate Officer Sep 26, 2025
Harold Odden Individual Corporate Officer Sep 26, 2025
Malik King Individual Corporate Officer Sep 26, 2025
Timothy Price Individual Corporate Officer Sep 26, 2025
Raquel Kline Individual Corporate Officer Sep 26, 2025
Colin Lamont Individual Corporate DirectorCfo Sep 26, 2025
W-2 Managing Employee Sep 26, 2025
Autumn Nichole King Individual Corporate DirectorCeo Sep 26, 2025
W-2 Managing Employee Sep 26, 2025
Ashley Piercy Individual Corporate DirectorCoo Sep 26, 2025
W-2 Managing Employee Sep 26, 2025
Phyllis Bragg Individual Corporate Officer Sep 26, 2025
D'Andrae Douse Individual Corporate Officer Sep 26, 2025

Practitioners & affiliated clinicians

Practitioners 54

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 54

NPI Registry JSON

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

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1013880913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 LAFAYETTE ST STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061100",
            "telephone_number": "260-266-0780",
            "fax_number": "260-266-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 S WESTERN AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469533556",
            "telephone_number": "260-266-0780",
            "fax_number": "260-266-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE HEALTH CENTERS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "AUTUMN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-266-0780"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.