NPIMap

Organization Active NPI

Alliance Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
National Provider Identifier
1336090265
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALLIANCE HEALTH CENTERS INC.
Practice address
2135 S Hanna St Ste 2
Fort Wayne, IN 46803-2402
Phone
(260) 266-0780
Fax
(260) 266-0785
NPI assigned
Feb 6, 2026
Last updated
Feb 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Authorized official

Name
Colin Lamont
Title
Director of Finance
Phone
(260) 266-0780

Specialties & licenses 1

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

Addresses

Primary practice location

2135 S Hanna St Ste 2
Fort Wayne, IN 46803-2402

Mailing address

2700 Lafayette St Ste 110
Fort Wayne, IN 46806-1100
Phone (260) 266-0780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201006002848 IN Part B Supplier - Clinic/Group Practice 8022437318 Receives reassigned benefits from 54 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Wayne, IN; Marion, IN; Auburn, IN
O20260302002668 IN Part A Provider - Federally Qualified Health Center (FQHC) 8022437318 Practice locations: Fort Wayne, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336090265. Details of each certification follow.

Federally qualified health center certification: CCN C51118

Legal name
ALLIANCE HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 26, 2026
Last certification
Feb 26, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2135 S Hanna St
Ste 2
Fort Wayne, IN 46803-2402

Other NPIs with the same Medicare PAC ID 9

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
Alliance Health Centers Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2135 S Hanna St
Ste 2
Fort Wayne, IN 46803

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Fernando Zapari Individual Corporate Officer Feb 6, 2026
Connie Heflin Individual Corporate Officer Feb 6, 2026
Melissa Grossman Individual Corporate Officer Feb 6, 2026
Philip Giaquinta Individual Corporate Officer Feb 6, 2026
Joseph Jordan Individual Corporate Officer Feb 6, 2026
Harold Odden Individual Corporate Officer Feb 6, 2026
Malik King Individual Corporate Officer Feb 6, 2026
Timothy Price Individual Corporate Officer Feb 6, 2026
Raquel Kline Individual Corporate Officer Feb 6, 2026
Colin Lamont Individual Corporate DirectorDirector of Finance Feb 6, 2026
W-2 Managing Employee Feb 6, 2026
Autumn Nichole King Individual Corporate DirectorCeo Feb 6, 2026
W-2 Managing Employee Feb 6, 2026
Ashley Piercy Individual Corporate DirectorCoo Feb 6, 2026
W-2 Managing Employee Feb 6, 2026
Phyllis Bragg Individual Corporate Officer Feb 6, 2026
D'Andrae Douse Individual Corporate Officer Feb 6, 2026

NPI Registry JSON

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

{
    "created_epoch": "1770336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770336000000",
    "number": "1336090265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 LAFAYETTE ST STE 110",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061100",
            "telephone_number": "260-266-0780",
            "fax_number": "260-266-0785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2135 S HANNA ST STE 2",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468032402",
            "telephone_number": "260-266-0780",
            "fax_number": "260-266-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE HEALTH CENTERS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-06",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A",
        "authorized_official_last_name": "LAMONT",
        "authorized_official_first_name": "COLIN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "260-266-0780"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.