NPIMap

Organization Active NPI

Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Lincoln Park, MI
National Provider Identifier
1508280116
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WESTERN WAYNE FAMILY HEALTH CENTERS
Practice address
25650 Outer Dr
Lincoln Park, MI 48146-2096
Phone
(313) 383-1897
Fax
(313) 383-6018
NPI assigned
Feb 18, 2014
Last updated
Apr 15, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
WESTERN WAYNE SOUTHWEST CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Ms. Linda R Atkins
Title
Ceo
Phone
(734) 941-4991

Specialties & licenses 1

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

Addresses

Primary practice location

25650 Outer Dr
Lincoln Park, MI 48146-2096

Mailing address

26650 Eureka Rd
Suite C-1
Taylor, MI 48180-4835
Phone (734) 941-4991

Other names 1

  • Western Wayne Family Health Centers - Lincoln Park Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060926000287 MI Part B Supplier - Clinic/Group Practice 4082617998 Receives reassigned benefits from 43 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dearborn, MI; Ecorse, MI; Inkster, MI; Lincoln Park, MI; Taylor, MI
O20140414000863 MI Part A Provider - Federally Qualified Health Center (FQHC) 4082617998 Practice locations: Lincoln Park, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508280116. Details of each certification follow.

Federally qualified health center certification: CCN 231028

Legal name
WESTERN WAYNE FAMILY HEALTH CENTERS
Doing business as
WESTERN WAYNE SOUTHWEST CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 15, 2014
Last certification
Apr 15, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 2, 2004 in MI
Enrollment address
25650 Outer Dr
Lincoln Park, MI 48146-2096

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 4

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

National Provider Directory

National Provider Directory
Tax ID family
Western Wayne FH Centers7 organizations share this tax ID, including this one
Part of
Western Wayne FH Centers

Other organizations with this tax ID 6

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

Locations

25650 Outer Dr
Lincoln Park, MI 48146
Phone (313) 294-1515

26650 Eureka Rd
Ste C
Taylor, MI 48180
Phone (734) 941-4991

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Saif Alsenad Individual Corporate Director Oct 1, 2023
Melissa Stellini Individual Corporate DirectorSecretary Dec 1, 2018
Walter Starghill Individual Corporate DirectorChairman Apr 21, 2011
Linda Atkins Individual Corporate Director Nov 18, 2008
W-2 Managing EmployeeCeo Nov 18, 2008
Arnold Gregory Individual Corporate Director Aug 1, 2022
Steven D Smith Individual Corporate Director Nov 3, 2021
Rachel M Cushman Individual Corporate Director Aug 1, 2022
Christina Arnold Individual Corporate Director Aug 1, 2013
William Miller Individual Corporate DirectorTreasurer Sep 1, 2014
Velma Jean Overman Individual Corporate DirectorVice Chairperson Mar 1, 2013
Carlotta Mitchell Individual Corporate Director Nov 21, 2023
Anita Goree Individual Corporate Director Feb 1, 2018

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1508280116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26650 EUREKA RD",
            "address_2": "SUITE C-1",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804835",
            "telephone_number": "734-941-4991",
            "fax_number": "734-941-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25650 OUTER DR",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462096",
            "telephone_number": "313-383-1897",
            "fax_number": "313-383-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WAYNE FAMILY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN WAYNE SOUTHWEST CENTER",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "ATKINS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "734-941-4991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Wayne Family Health Centers - Lincoln Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lincoln Park, MI

Sources for this page

Verify at the official NPI Registry.