NPIMap

Organization Active NPI

Echo Community Health Care, Inc.

Doing business as Division Street Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Evansville, IN
National Provider Identifier
1467483255
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ECHO COMMUNITY HEALTH CARE, INC.
Doing business as
Division Street Family Clinic
Practice address
25 W Division St
Evansville, IN 47710-1374
Phone
(812) 436-0205
Fax
(812) 436-0207
NPI assigned
Jul 6, 2006
Last updated
Jul 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Authorized official

Name
Sandee Strader-McMillen
Title
Ceo
Phone
(812) 421-7489

Specialties & licenses 1

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

Addresses

Primary practice location

25 W Division St
Evansville, IN 47710-1374

Mailing address

315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489

Other identifiers 1

IdentifierTypeStateIssuer
200079040MedicaidIN

Other names 1

  • Division Street Family Clinic Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030911000023 IN Part A Provider - Federally Qualified Health Center (FQHC) 4981515145 Practice locations: Evansville, IN
O20040721001319 IN Part B Supplier - Clinic/Group Practice 4981515145 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Evansville, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467483255. Details of each certification follow.

Federally qualified health center certification: CCN 151824

Legal name
ECHO COMMUNITY HEALTH CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 17, 2003
Last certification
Sep 17, 2003
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 18, 1989 in IN
Enrollment address
25 W Division St
Evansville, IN 47710-1374
Related CCNs
151817

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

25 W Division St
Evansville, IN 47710
Phone (812) 436-0205

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
Mike Cameron Individual Corporate DirectorDirector Jan 1, 2013
Aleise Barron Individual Corporate DirectorBoard Member Apr 18, 2023
Brad Gant Individual Corporate DirectorBoard Member Apr 18, 2023
Sandee Strader McMillen Individual Corporate OfficerCeo Aug 12, 2009
Myers Hyman Individual Corporate DirectorDirector Aug 3, 2012
Jason Emmerson Individual Corporate DirectorBoard Member Jan 1, 2019
Gerald Arnold Individual Corporate Director Jan 1, 2009
Zachary Ward Individual Corporate DirectorBoard Member Sep 21, 2021
Lindsey Johnson Individual Corporate Director Feb 26, 2026
Alan G Swartz Individual Corporate OfficerCoo Oct 1, 2024
W-2 Managing EmployeeCoo Oct 1, 2024
Cindy L Shea Individual Corporate OfficerCfo Jul 18, 2011
Lula Porter Individual Corporate Director Jan 1, 2009
Jennifer Arnold Individual Corporate DirectorBoard Member Jul 2, 2022

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1467483255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131252",
            "telephone_number": "812-421-7489",
            "fax_number": "812-436-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W DIVISION ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101374",
            "telephone_number": "812-436-0205",
            "fax_number": "812-436-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECHO COMMUNITY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "STRADER-MCMILLEN",
        "authorized_official_first_name": "SANDEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-421-7489"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200079040",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Division Street Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.