NPIMap

Organization Active NPI

Echo Community Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Evansville, IN
National Provider Identifier
1063805216
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ECHO COMMUNITY HEALTH CARE, INC
Practice address
315 Mulberry St
Evansville, IN 47713-1252
Phone
(812) 421-7489
Fax
(812) 436-0209
NPI assigned
Mar 12, 2015
Last updated
Aug 8, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ECHO COMMUNITY HEALTH CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Sandee Strader-McMillen
Title
Ceo
Phone
(812) 421-7489

Specialties & licenses 1

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

Addresses

Primary practice location

315 Mulberry St
Evansville, IN 47713-1252

Mailing address

316 Chandler Ave
Evansville, IN 47713-1147
Phone (812) 436-4501

Other identifiers 1

IdentifierTypeStateIssuer
200079040MedicaidIN

Other names 1

  • ECHO Pediatric & Prenatal Clinic Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040721001319 IN Part B Supplier - Clinic/Group Practice 4981515145 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Evansville, IN
O20150421001234 IN Part A Provider - Federally Qualified Health Center (FQHC) 4981515145 Practice locations: Evansville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063805216. Details of each certification follow.

Federally qualified health center certification: CCN 151940

Legal name
ECHO COMMUNITY HEALTH CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 20, 2015
Last certification
Apr 20, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
316 Chandler Ave
Evansville, IN 47713-1147

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 5

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

National Provider Directory

National Provider Directory
Tax ID family
Echo Community Health3 organizations share this tax ID, including this one
Part of
Echo Community Health

Other organizations with this tax ID 2

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

Locations

410 Mulberry St
Evansville, IN 47713
Phone (812) 421-7489

801 Saint Marys Dr
#309
Evansville, IN 47714
Phone (812) 485-4455

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Mike Cameron Individual Corporate DirectorDirector Aug 21, 2021
Aleise Barron Individual Corporate DirectorBoard Member Apr 18, 2023
Robert Royer Individual Corporate DirectorDirector Oct 22, 2009
Brad Gant Individual Corporate DirectorBoard Member Apr 18, 2023
Sandee Strader McMillen Individual Corporate OfficerCeo May 21, 2007
W-2 Managing Employee May 21, 2007
Myers Hyman Individual Corporate DirectorDirector Aug 3, 2012
Jason Emmerson Individual Corporate DirectorBoad Member Jan 1, 2019
Gerald Arnold Individual Corporate DirectorDirector Oct 21, 2007
Zachary Ward Individual Corporate DirectorBoard Member Sep 21, 2021
Alan G Swartz Individual Corporate OfficerCoo Oct 1, 2024
W-2 Managing EmployeeCoo Oct 1, 2024
Cindy L Shea Individual Corporate OfficerCfo Jul 18, 2011
W-2 Managing EmployeeCfo Jul 18, 2011
Lula Porter Individual Corporate DirectorDirector Aug 9, 2000
Jennifer Arnold Individual Corporate DirectorBoard Member Jul 2, 2022
Andrew Schenk Individual Corporate DirectorBoard Member Jan 18, 2024

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1063805216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 CHANDLER AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131147",
            "telephone_number": "812-436-4501",
            "fax_number": "812-436-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131252",
            "telephone_number": "812-421-7489",
            "fax_number": "812-436-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECHO COMMUNITY HEALTH CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ECHO COMMUNITY HEALTH CARE INC",
        "enumeration_date": "2015-03-12",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "STRADER-MCMILLEN",
        "authorized_official_first_name": "SANDEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-421-7489"
    },
    "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": "200079040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECHO Pediatric & Prenatal Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.