NPIMap

Organization Active NPI

Center for Family Health

  • Federally Qualified Health Center (FQHC)
  • Jackson, MI
National Provider Identifier
1366740342
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CENTER FOR FAMILY HEALTH
Practice address
544 Wildwood Ave
Jackson, MI 49201-1013
Phone
(517) 780-0838
Fax
(517) 780-0689
NPI assigned
Mar 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Ms. Molly Kaser
Title
Ceo
Phone
(517) 748-5500

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

544 Wildwood Ave
Jackson, MI 49201-1013

Mailing address

505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500

Other names 1

  • Jackson High Teen Health Center Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcaryl@cfhinc.org Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040219000916 MI Part B Supplier - Clinic/Group Practice 4587574421 Receives reassigned benefits from 52 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jackson, MI
O20110315000483 MI Part A Provider - Federally Qualified Health Center (FQHC) 4587574421 Practice locations: Jackson, MI

Federally qualified health center certification: CCN 231953

Legal name
CENTER FOR FAMILY HEALTH
Doing business as
CENTER FOR FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 30, 2011
Last certification
Mar 30, 2011
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1995 in MI
Enrollment address
544 Wildwood Ave
Jackson, MI 49201-1013

Other NPIs with the same Medicare PAC ID 7

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
Center for Family Healt10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
William M Wypyski Individual Corporate DirectorCeo Sep 1, 2023
W-2 Managing EmployeeCeo Sep 1, 2023 100%
Karen Sue Barrett Individual Corporate OfficerBoard Member May 1, 2016
Randall Wesley Treacher Individual Corporate OfficerBoard Member Jun 1, 2016
Zoe Lynn Lyons Individual Corporate OfficerBoard Member Feb 1, 2019
Jessica Marie Embury Individual Corporate OfficerBoard Member Nov 1, 2018
Lori Heiler Individual Corporate DirectorBoard Member Mar 1, 2011
Center for Family Health Organization, Jackson, MI Non-profit Operational/Managerial Control May 31, 2023 100%
Lee Hampton Individual Corporate OfficerBoard Member Mar 1, 2012
Steven Hogwood Individual Corporate DirectorBoard Member Mar 1, 2011
Ralph Dale Moretz Individual Corporate DirectorBoard Member Mar 1, 2011
William J Patterson Individual Corporate DirectorBoard Member Mar 1, 2011
Theodore Hilleary Individual Corporate DirectorBoard Member Mar 1, 2011
Jennifer White Individual Corporate OfficerBoard Member Apr 1, 2013

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Center for Family Health- BlackstoneJackson, MI, CCN C71014 Federally qualified health center Operational/Managerial Control (100%) Dec 1, 2023

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1366740342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500",
            "fax_number": "517-780-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 WILDWOOD AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011013",
            "telephone_number": "517-780-0838",
            "fax_number": "517-780-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "KASER",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "517-748-5500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcaryl@cfhinc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "544 Wildwood Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Jackson High Teen Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jackson High Teen Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.