NPIMap

Organization Active NPI

Isabella Citizens for Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mt Pleasant, MI
National Provider Identifier
1104177195
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
#LAL000164
Legal business name
ISABELLA CITIZENS FOR HEALTH, INC.
Practice address
2790 Health Pkwy
Mt Pleasant, MI 48858
Phone
(989) 953-5320
Fax
(989) 953-5329
NPI assigned
Oct 1, 2012
Last updated
Nov 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Jennifer Lynn White
Title
Ceo
Phone
(989) 953-5191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X #LAL000164 Primary

Addresses

Primary practice location

2790 Health Pkwy
Mt Pleasant, MI 48858

Mailing address

2790 Health Pkwy
Mt Pleasant, MI 48858-6934
Phone (989) 953-5320

Other identifiers 1

IdentifierTypeStateIssuer
23-1038OtherMIMEDICARE CCN

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130516000164 MI Part B Supplier - Clinic/Group Practice 9335386051 Receives reassigned benefits from 38 practitioners
11 other NPIs on this enrollment
Practice locations: Farwell, MI; Mount Pleasant, MI
O20141028000515 MI Part A Provider - Federally Qualified Health Center (FQHC) 9335386051 Practice locations: Mt Pleasant, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104177195. Details of each certification follow.

Federally qualified health center certification: CCN 231038

Legal name
ISABELLA CITIZENS FOR HEALTH INC
Doing business as
ISABELLA CITIZENS FOR HEALTH INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 5, 2014
Last certification
Dec 5, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2790 Health Pkwy
Mt Pleasant, MI 48858-6934

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 11

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

National Provider Directory

National Provider Directory

Locations

1201 South Dr
Ste 220
Mt Pleasant, MI 48858
Phone (989) 773-3411

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
James Wojcik Individual Corporate DirectorBoard Member Nov 2, 2021 8%
Lisa Hadden Individual Corporate DirectorBoard Member Feb 16, 2018 8%
Michael L McConnon Individual Corporate DirectorMedical Director Jan 1, 2018 10%
Albert Kaufmann Individual Corporate DirectorBoard Member Oct 10, 2011 8%
Jennifer L White Individual Corporate OfficerExecutive Director May 24, 2013
W-2 Managing EmployeeExecutive Director May 24, 2013
Helen L Lee Individual Corporate DirectorBoard Member Sep 28, 2011 8%
Anthony Kulick Individual Corporate DirectorBoard Member Feb 1, 2016 8%
Leanne K Barton Individual Corporate DirectorBoard Member Sep 28, 2011 8%
Cheri Hall Individual Corporate DirectorBoard Member Dec 3, 2024
Mary Ann O'Neil Individual Corporate Director Feb 1, 2022 8%
Steven Hall Individual Corporate DirectorBoard Member Sep 8, 2014 8%
Brian Ross Individual W-2 Managing EmployeeChief Financial Officer Sep 1, 2024
Rachel Blizzard Individual W-2 Managing EmployeeChief Operating Officer Dec 1, 2021
Jen Crawford Individual Corporate DirectorBoard Member Feb 2, 2021 8%
Brad Wahr Individual Corporate DirectorBoard Member Feb 1, 2022 8%
Isabella Citizens for Health Inc Organization, Mt Pleasant, MI Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Feb 11, 2013 100%
Tara Hovey Individual Corporate DirectorBoard Member Feb 1, 2022 8%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Women's Health Center of Isabella Citizens for Health, IncMt Pleasant, MI, CCN C71005 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 38

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 38

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1104177195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488586934",
            "telephone_number": "989-953-5320",
            "fax_number": "989-953-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 HEALTH PKWY",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-953-5320",
            "fax_number": "989-953-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISABELLA CITIZENS FOR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-953-5191"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": "#LAL000164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CCN",
            "identifier": "23-1038",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.