NPIMap

Organization Active NPI

Family Health Center Inc

Doing business as Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
National Provider Identifier
1215768296
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTER INC
Doing business as
Family Health Center
Practice address
2501 Millcork St
Kalamazoo, MI 49001-4642
Phone
(269) 349-2641
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Denise CrawfordNPI 1386688430
Title
President and Ceo
Phone
(269) 349-4257

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2501 Millcork St
Kalamazoo, MI 49001-4642

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Other names 1

  • Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040510000899 MI Part B Supplier - Clinic/Group Practice 1759370216 Receives reassigned benefits from 133 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kalamazoo, MI
O20241031003409 MI Part A Provider - Federally Qualified Health Center (FQHC) 1759370216 Practice locations: Kalamazoo, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215768296. Details of each certification follow.

Federally qualified health center certification: CCN C71034

Legal name
FAMILY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 2024
Last certification
Nov 1, 2024
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1971 in MI
Enrollment address
2501 Millcork St
Kalamazoo, MI 49001-4642

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 9

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

National Provider Directory

National Provider Directory
Tax ID family
Steve Reiman DO6 organizations share this tax ID, including this one
Part of
Steve Reiman DO

Other organizations with this tax ID 5

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

Locations

2501 Millcork St
Kalamazoo, MI 49001

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Denise R Crawford Individual Corporate OfficerChief Executive Officer Feb 23, 2009
Corporate DirectorChief Executive Officer Feb 23, 2009
W-2 Managing Employee Feb 23, 2009
Efeosa Idemudia Individual Corporate Director Jan 1, 2019
Adrian Vazquez Individual Corporate Director Jan 1, 2018
Jacqueline Marie Luttrell Individual Corporate Director Jan 1, 2015
Keela Hemphill Individual Corporate Director Jan 1, 2022
Aaron Lane-Davies Individual Corporate Director Jan 1, 2019
Tiffany Fuller Individual Corporate Director Jan 1, 2022
Patrick Allen Troman Individual Corporate Director Jan 1, 2019
Eileen Chiang Individual Corporate Officer Feb 15, 2010
Corporate DirectorChief Financial Officer Feb 15, 2010
W-2 Managing Employee Feb 15, 2010
Prabhash Tatineni Individual Corporate Director Jan 1, 2023
Cathy Ash Individual Corporate Director Jan 1, 2016
Christine Beverly Individual Corporate Director Jan 1, 2020
Roberto Flachier Individual Corporate Director Jan 1, 2018

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 133

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 133

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1215768296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 MILLCORK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490014642",
            "telephone_number": "269-349-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH CENTER INC",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "269-349-4257"
    },
    "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": "Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.