NPIMap

Organization Active NPI

Hackley Community Care Center Inc

Doing business as Oakridge Lower Elementary School

  • Federally Qualified Health Center (FQHC)
  • Muskegon, MI
National Provider Identifier
1073021754
Registry record updated May 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HACKLEY COMMUNITY CARE CENTER INC
Doing business as
Oakridge Lower Elementary School
Practice address
120 N Park St Ste a
Muskegon, MI 49442-1722
Phone
(231) 788-7600
NPI assigned
Jan 17, 2018
Last updated
May 11, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
HACKLEY COMMUNITY CARE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2018

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

Authorized official

Name
Jo Ann Paprocki
Title
Billing Manager
Phone
(231) 733-6804

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

120 N Park St Ste a
Muskegon, MI 49442-1722

Mailing address

2700 Baker St FL 3
Muskegon, MI 49444-2157

Other identifiers 1

IdentifierTypeStateIssuer
1629066238MedicaidMI

Other names 1

  • Oakridge Lower Elementary School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hackley Community Care31 organizations share this tax ID, including this one
Part of
Hackley Community Care

Other organizations with this tax ID 30

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

View all 30

Locations

120 N Park St
Ste A
Muskegon, MI 49442
Phone (231) 788-7600

Practitioners & affiliated clinicians

Practitioners 2

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": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1073021754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N PARK ST STE A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494421722",
            "telephone_number": "231-788-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY COMMUNITY CARE CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HACKLEY COMMUNITY CARE CENTER INC",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "PAPROCKI",
        "authorized_official_first_name": "JO ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "231-733-6804"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "1629066238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakridge Lower Elementary School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.