NPIMap

Baldwin Family Health Care

Organization Active NPI Federally Qualified Health Center (FQHC) · Big Rapids, MI

NPI 1275340010 · NPPES record last updated Dec 16, 2024

Key facts

NPI
1275340010
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
BALDWIN FAMILY HEALTH CARE
Practice address
15044 220TH Ave
Big Rapids, MI 49307-9248
Phone
(231) 527-7150
Fax
(231) 796-4109
NPI assigned
Dec 16, 2024
Organization subpart
Yes
Parent organization (as reported)
BALDWIN FAMILY HEALTH CARE

Authorized official

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

Other NPIs on the same Medicare enrollment 17

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

Other NPIs with the same Medicare PAC ID 18

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

Corporate family (same tax ID) 22

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

Practitioners 36

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

View all 36

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

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
Corporation · Non-profit
Enrollment address
15044 220TH Ave
Big Rapids, MI 49307-9248

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 Director
Board 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 Director
Past Chair		 Apr 1, 1992
Eric Davidson
Individual 		Corporate Director
Vice Chair		 Sep 1, 1986
Seth Wenger
Individual 		Corporate Director
Treasurer		 Jul 1, 2024
Julie Tatko
Individual 		Corporate Officer
Ceo		 Sep 1, 2020
W-2 Managing Employee
Ad;		 Sep 1, 2020
David Glancy
Individual 		Corporate Director Jul 1, 2024
Mason Husby
Individual 		Corporate Officer
Cfo		 Apr 1, 2018

Medicare enrollment records

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

National Provider Directory

Tax ID family
Rowland Family Health C (23 organizations share this tax ID)
Part of
Rowland Family Health C

Specialties & licenses

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

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

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

Other providers in Big Rapids, MI

All providers in Big Rapids, MI · Federally Qualified Health Center (FQHC) in Michigan

Sources for this page

Verify at the official NPI Registry.