NPIMap

Organization Active NPI

Baldwin Family Health Care

Doing business as Family Health Care - Big Rapids 220th ave

  • Federally Qualified Health Center (FQHC)
  • Big Rapids, MI
National Provider Identifier
1275340010
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BALDWIN FAMILY HEALTH CARE
Doing business as
Family Health Care - Big Rapids 220th ave
Practice address
15044 220TH Ave
Big Rapids, MI 49307-9248
Phone
(231) 527-7150
Fax
(231) 796-4109
NPI assigned
Dec 16, 2024
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BALDWIN FAMILY HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Julie Tatko
Title
Ceo
Phone
(231) 745-5482

Specialties & licenses 1

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

Addresses

Primary practice location

15044 220TH Ave
Big Rapids, MI 49307-9248

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 876-6527

Other names 1

  • Family Health Care - Big Rapids 220th ave Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040209001155 MI Part B Supplier - Clinic/Group Practice 1153215413 Receives reassigned benefits from 50 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grant, MI; Kent City, MI; Leroy, MI; McBain, MI; Newaygo, MI; Reed City, MI; White Cloud, MI; Cadillac, MI…
O20250115003515 MI Part A Provider - Federally Qualified Health Center (FQHC) 1153215413 Practice locations: Big Rapids, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275340010. Details of each certification follow.

Federally qualified health center certification: CCN C71040

Legal name
BALDWIN FAMILY HEALTH CARE
Doing business as
FAMILY HEALTH CARE - BIG RAPIDS 220TH AVE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 10, 2025
Last certification
Jan 10, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
15044 220TH Ave
Big Rapids, MI 49307-9248

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Rowland Family Health C23 organizations share this tax ID, including this one
Part of
Rowland Family Health C

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Pamela Panetta Individual Corporate DirectorBoard Chair Sep 27, 2018
Ashley Hawkins Individual Corporate Director Jan 23, 2023
Susan Olds Individual Corporate Director Jul 25, 2019
Mary Martin Individual Corporate Director Jul 25, 2022
Corey Vanfleet Individual Corporate Director May 1, 1996
Robert Fisher Individual Corporate DirectorPast Chair Apr 1, 1992
Eric Davidson Individual Corporate DirectorVice Chair Sep 1, 1986
Seth Wenger Individual Corporate DirectorTreasurer Jul 1, 2024
Julie Tatko Individual Corporate OfficerCeo Sep 1, 2020
W-2 Managing EmployeeAd; Sep 1, 2020
David Glancy Individual Corporate Director Jul 1, 2024
Mason Husby Individual Corporate OfficerCfo Apr 1, 2018

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1275340010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-876-6527",
            "fax_number": "231-876-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15044 220TH AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493079248",
            "telephone_number": "231-527-7150",
            "fax_number": "231-796-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALDWIN FAMILY HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BALDWIN FAMILY HEALTH CARE",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "TATKO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-745-5482"
    },
    "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 Care - Big Rapids 220th ave",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Big Rapids, MI

Sources for this page

Verify at the official NPI Registry.