NPIMap

Organization Active NPI

Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Omak, WA
National Provider Identifier
1306005715
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
600625131 Issued in WA
Legal business name
FAMILY HEALTH CENTERS
Practice address
1003 Koala Dr.
Omak, WA 98841
Phone
(509) 422-5700
Fax
(509) 422-7680
NPI assigned
Jun 2, 2008
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Jesus Hernandez
Title
Ceo
Phone
(509) 422-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 600625131 WA Primary

Addresses

Primary practice location

1003 Koala Dr.
Omak, WA 98841

Mailing address

PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-5700

Other names 1

  • Okanogan Farm Workers Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081211000834 WA Part A Provider - Federally Qualified Health Center (FQHC) 9739076217 Practice locations: Omak, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306005715. Details of each certification follow.

Federally qualified health center certification: CCN 501836

Legal name
FAMILY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1995
Last certification
Jul 1, 1995
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 1985 in WA
Enrollment address
1003 Koala Dr
Omak, WA 98841-9247

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Family Health Centers23 organizations share this tax ID, including this one
Part of
Family Health Centers

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
Charlene a Burns Individual Corporate Director Apr 1, 2019
George Thornton Individual Corporate Director Mar 1, 2016
Caludia Lee Miller Individual Corporate Director Jun 1, 2018
Teresa Trejo Individual Corporate Director May 1, 2017
Jose Luna Individual Corporate Director Jun 1, 2018
Ayde Garza Individual Corporate Director Jun 1, 2014
Cesilia Brooks Individual Corporate Director Dec 1, 2015
Jesus Hernandez Individual W-2 Managing EmployeeCeo Mar 14, 2016
Parker Parsons Individual Corporate Director Dec 12, 2008
Peter Morgan Individual Corporate DirectorBoard Member Feb 1, 2012
Charles Root Individual Corporate Director Dec 12, 2008

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Family Health CentersBridgeport, WA, CCN 501968 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014
Family Health Centers TwispTwisp, WA, CCN 941000 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2015
May 1, 2015

Owned or controlled facilities with NPI records 2

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

  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Bridgeport, WA
    • NPI 1497176390

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Twisp, WA
    • NPI 1679962401

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1306005715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 KOALA DR.",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "98841",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH CENTERS",
        "enumeration_date": "2008-06-02",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-422-5700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600625131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Okanogan Farm Workers Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.