NPIMap

Organization Active NPI

East Jordan Family Health Center

Doing business as Bellaire Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Bellaire, MI
National Provider Identifier
1376750091
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
EAST JORDAN FAMILY HEALTH CENTER
Doing business as
Bellaire Family Health Center
Practice address
4955 S M 88 Hwy
Bellaire, MI 49615-9082
Phone
(231) 533-8649
NPI assigned
May 16, 2007
Last updated
Dec 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Authorized official

Name
Daniel McKinnon
Title
Ceo
Phone
(231) 536-2206

Specialties & licenses 1

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

Addresses

Primary practice location

4955 S M 88 Hwy
Bellaire, MI 49615-9082

Mailing address

4955 S M 88 Hwy
Bellaire, MI 49615-9082
Phone (231) 533-8649

Other names 1

  • Bellaire Family Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040210000099 MI Part B Supplier - Clinic/Group Practice 8325932510 Receives reassigned benefits from 28 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellaire, MI; Central Lake, MI; East Jordan, MI
O20060907000200 MI Part A Provider - Federally Qualified Health Center (FQHC) 8325932510 Practice locations: Bellaire, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376750091. Details of each certification follow.

Federally qualified health center certification: CCN 231916

Legal name
EAST JORDAN FAMILY HEALTH CENTER
Doing business as
BELLAIRE FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 13, 2006
Last certification
Sep 13, 2006
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 5, 1976 in MI
Enrollment address
4955S M 88 Hwy
Bellaire, MI 49615-9082

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Bellaire Family Health Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

307 E Cayuga St
Bellaire, MI 49615
Phone (231) 533-8649

601 Bridge St
East Jordan, MI 49727
Phone (231) 536-2206

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Cara Griffiths Individual Corporate OfficerSecretary Nov 7, 2013
Diane Hawley Individual Corporate DirectorChief Operating Officer Jan 1, 1981
Leslie a Meyers Individual Corporate DirectorDirector Feb 4, 2021
Timothy Kish Individual Corporate OfficerVice-Chairperson Feb 7, 2019
Daniel McKinnon Individual W-2 Managing EmployeeCeo Nov 30, 1992
Brian D Olszewski Individual Corporate OfficerTreasurer Apr 1, 2021
Patricia Savant Individual Corporate DirectorDirector Apr 26, 2012
Mary Ann Scott Individual Corporate DirectorDirector Jul 14, 2017
Janelle Kassien Individual Corporate OfficerPresident Jan 1, 2021

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1376750091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 S M 88 HWY",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159082",
            "telephone_number": "231-533-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S M 88 HWY",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159082",
            "telephone_number": "231-533-8649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST JORDAN FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "MCKINNON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-536-2206"
    },
    "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": "Bellaire Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellaire, MI

Sources for this page

Verify at the official NPI Registry.