NPIMap

Organization Active NPI

Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
National Provider Identifier
1023560331
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTER, INC.
Practice address
505 E Alcott St
Kalamazoo, MI 49001
Phone
(269) 349-2641
Fax
(269) 349-2898
NPI assigned
Nov 3, 2016
Last updated
Nov 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Authorized official

Name
Denise Crawford
Title
Executive Director & Ceo
Phone
(269) 349-2641

Specialties & licenses 1

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

Addresses

Primary practice location

505 E Alcott St
Kalamazoo, MI 49001

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040510000899 MI Part B Supplier - Clinic/Group Practice 1759370216 Receives reassigned benefits from 133 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kalamazoo, MI
O20170327002600 MI Part A Provider - Federally Qualified Health Center (FQHC) 1759370216 Practice locations: Kalamazoo, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023560331. Details of each certification follow.

Federally qualified health center certification: CCN 231108

Legal name
FAMILY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 25, 2017
Last certification
Mar 25, 2017
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
505 E Alcott St
Kalamazoo, MI 49001

Other NPIs with the same Medicare PAC ID 3

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
Steve Reiman DO6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

1308 N Burdick St
Kalamazoo, MI 49007
Phone (269) 488-0803

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Denise R Crawford Individual Corporate OfficerChief Executive Officer Feb 23, 2009
Corporate DirectorChief Executive Officer Feb 23, 2009
W-2 Managing EmployeeChief Executive Officer Feb 23, 2009
Efeosa Idemudia Individual Corporate DirectorBoard Member Jan 1, 2019
Adrian Vazquez Individual Corporate OfficerBoard Member Jan 1, 2018
Keela Hemphill Individual Corporate DirectorBoard Member Jan 1, 2022
Aaron Lane-Davies Individual Corporate DirectorBoard Member Jan 1, 2019
Tiffany Fuller Individual Corporate DirectorBoard Member Jan 1, 2022
Patrick Allen Troman Individual Corporate DirectorBoard Member Jan 1, 2019
Eileen Chiang Individual Corporate OfficerChief Financial Officer Feb 15, 2010
Corporate DirectorChief Financial Officer Feb 15, 2010
W-2 Managing Employee Feb 15, 2010
Prabhash Tatineni Individual Corporate Director Jan 1, 2023
Christine Beverly Individual Corporate DirectorBoard Member Jan 1, 2020
Roberto Flachier Individual Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1023560331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641",
            "fax_number": "269-349-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E ALCOTT ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49001",
            "telephone_number": "269-349-2641",
            "fax_number": "269-349-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR & CEO",
        "authorized_official_telephone_number": "269-349-2641"
    },
    "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 Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.