NPIMap

Organization Active NPI

Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
National Provider Identifier
1124369970
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTER FOR FAMILY HEALTH
Practice address
1200 N West Ave
Jackson, MI 49202-2179
Phone
(517) 748-5500
Fax
(517) 780-9286
NPI assigned
Mar 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Molly Kaser
Title
Ceo
Phone
(517) 748-5500

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

1200 N West Ave
Jackson, MI 49202-2179

Mailing address

505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500

Other names 1

  • Center for Family Health at Lifeways Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcaryl@cfhinc.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040214000170 MI Part B Supplier - Clinic/Group Practice 4587574421 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI
O20040219000916 MI Part B Supplier - Clinic/Group Practice 4587574421 Receives reassigned benefits from 52 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI
O20130725000840 MI Part A Provider - Federally Qualified Health Center (FQHC) 4587574421 Practice locations: Jackson, MI

Federally qualified health center certification: CCN 231008

Legal name
CENTER FOR FAMILY HEALTH
Doing business as
CENTER FOR FAMILY HEALTH LIFEWAYS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 27, 2013
Last certification
Jun 27, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1995 in MI
Enrollment address
1200 N West Ave
Jackson, MI 49202-2179

Other NPIs with the same Medicare PAC ID 7

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
William M Wypyski Individual Corporate DirectorCeo Nov 17, 2023
W-2 Managing EmployeeCeo Nov 17, 2023 100%
Randall Wesley Treacher Individual Corporate OfficerBoard Member Jun 1, 2016
Alisa Marie Anders Individual Corporate DirectorBoard Member Jan 1, 2024
Zoe Lynn Lyons Individual Corporate OfficerBoard Member Feb 1, 2019
Jacob Inosencio Individual Corporate OfficerBoard Member Jan 1, 2024
Jessica Marie Embury Individual Corporate OfficerBoard Member Nov 1, 2018
Shawna Marie Tello Individual Corporate OfficerBoard Member Jan 1, 2024
Lori Heiler Individual Corporate OfficerBoard Member Mar 1, 2011
Ralph Dale Moretz Individual Corporate OfficerBoard Member Mar 1, 2011
Sheila Troxel Individual Corporate OfficerBoard Member Jan 1, 2024
Theodore Hilleary Individual Corporate OfficerBoard Member Mar 1, 2011
Jennifer White Individual Corporate OfficerBoard Member Apr 1, 2013

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Center for Family HealthJackson, MI, CCN 231953 Federally qualified health center Operational/Managerial Control (100%) May 31, 2023
Center for Family Health- BlackstoneJackson, MI, CCN C71014 Federally qualified health center Operational/Managerial Control (100%) Dec 1, 2023

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1124369970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500",
            "fax_number": "517-780-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022179",
            "telephone_number": "517-748-5500",
            "fax_number": "517-780-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KASER",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "517-748-5500"
    },
    "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": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcaryl@cfhinc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1200 N West Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492022179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Center for Family Health at Lifeways",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Center for Family Health at Lifeways",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.