NPIMap

Organization Active NPI

Cherry Street Services Inc

Doing business as Barry Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Hastings, MI
National Provider Identifier
1265862841
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHERRY STREET SERVICES INC
Doing business as
Barry Community Health Center
Practice address
330 W Woodlawn Ave
Hastings, MI 49058-1035
Phone
(965) 945-4220
Fax
(296) 945-4229
NPI assigned
Nov 19, 2013
Last updated
Nov 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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

Authorized official

Name
Chris Shea
Title
Ceo
Phone
(616) 776-2120

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Social Worker 104100000X NU
Dentist 122300000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

330 W Woodlawn Ave
Hastings, MI 49058-1035

Mailing address

100 Cherry St SE
Grand Rapids, MI 49503-4526
Phone (616) 965-8200

Other names 1

  • Barry Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804000274 MI Part B Supplier - Clinic/Group Practice 6800707647 Receives reassigned benefits from 133 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Rapids, MI

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

  • Eric K Vandepol, MD
    • Emergency Medical Services (Emergency Medicine) Physician
    • Grand Rapids, MI
    • NPI 1205843125

    Internal Medicine

    NPD

NPI Registry JSON

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1265862841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CHERRY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034526",
            "telephone_number": "616-965-8200",
            "fax_number": "616-940-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W WOODLAWN AVE",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490581035",
            "telephone_number": "965-945-4220",
            "fax_number": "296-945-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY STREET SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-776-2120"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Barry Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hastings, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.