Great Lakes Bay Health Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

GREAT LAKES BAY HEALTH CENTERS

Practice address

1624 Columbus Ave
Bay City, MI 48708-6827

Phone

(989) 759-6464

NPI assigned

Feb 16, 2024

Organization subpart

No

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

Authorized official

Name

Lisa Galonska

Title

Vice President

Phone

(989) 759-6464

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Bay Health Centers Bay City Central Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Federally qualified health center certification: CCN C71026

Legal name

GREAT LAKES BAY HEALTH CENTERS

Doing business as

GREAT LAKES BAY HEALTH CENTERS BAY CITY CENTRAL

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jul 8, 2024

Last certification

Jul 8, 2024

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Nov 1, 1968 in MI

Enrollment address

1624 Columbus Ave
Bay City, MI 48708-6827

Tax ID family

Great Lakes Bay Health Centers67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Great Lakes Bay Health Center

  • Community/Retail Pharmacy
  • Bay City, MI
  • NPI 1194341834
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1023348406
  NPD tax ID
• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Bay City, MI
  • NPI 1033478391
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, MI
  • NPI 1073169835
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Owosso, MI
  • NPI 1134491202
  NPD tax ID
• Great Lakes Bay Health Centers

  • Counseling Psychologist
  • Ann Arbor, MI
  • NPI 1134652498
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1134918089
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1154920817
  NPD tax ID
• Great Lakes Bay Health Centers

  • Community/Retail Pharmacy
  • Saginaw, MI
  • NPI 1164502803
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Owosso, MI
  • NPI 1184054892
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Bad Axe, MI
  • NPI 1205226412
  NPD tax ID
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, MI
  • NPI 1215055306
  NPD tax ID

Locations

All disclosed owners & managing parties 19

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

Owners & managing parties with NPI records 2

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

• Brenda Marie Coughlin, MD

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1609864495

  W-2 Managing Employee

  CMS ownership
• John Arthur Martin, PA

  • Physician Assistant
  • Bay City, MI
  • NPI 1386632164

  Corporate Director

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Alison Prior, FNP-BC

  • Family Nurse Practitioner
  • Bay City, MI
  • NPI 1821377748
  NPD (past)

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1093570293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086827",
            "telephone_number": "989-759-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES BAY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "GALONSKA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "989-759-6464"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Bay Health Centers Bay City Central",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Bay Health Centers Bay City Central",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Catherine Grames
• Jessica Gray
• Madison Lucille Gray, OTRL
• Great Lakes Bay Health Center
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers
• Great Lakes Bay Health Centers

• All providers in Bay City, MI
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.