NPIMap

Organization Active NPI

G a Carmichael Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Yazoo City, MS
National Provider Identifier
1508922675
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
G A CARMICHAEL FAMILY HEALTH CENTER INC
Practice address
1206 Grand Ave
Yazoo City, MS 39194-2949
Phone
(662) 746-6532
Fax
(601) 859-8771
NPI assigned
Dec 30, 2006
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Dr. James L. Coleman, ED.D.
Title
Ceo
Phone
(601) 859-5213

Specialties & licenses 1

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

Addresses

Primary practice location

1206 Grand Ave
Yazoo City, MS 39194-2949

Mailing address

1668 W Peace St
Canton, MS 39046-5332
Phone (601) 859-5213

Other identifiers 2

IdentifierTypeStateIssuer
09011452MedicaidMS
251809OtherMSMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050816001055 MS Part B Supplier - Clinic/Group Practice 2567371032 Receives reassigned benefits from 24 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belzoni, MS; Yazoo City, MS; Vaughan, MS; Greenwood, MS; Carthage, MS; Canton, MS; Bentonia, MS
O20101213000979 MS Part A Provider - Federally Qualified Health Center (FQHC) 2567371032 Practice locations: Yazoo City, MS
O20240122002587 MS MDPP Supplier - in-Person MDPP Supplier 2567371032 Practice locations: Yazoo City, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508922675. Details of each certification follow.

Federally qualified health center certification: CCN 251809

Legal name
G A CARMICHAEL FAMILY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 1973 in MS
Enrollment address
1547 Jerry Clower Blvd
Yazoo City, MS 39194-2718

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
M Y L Family Health Ctr26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

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
Rosie Evan-Williams Individual Corporate Director Oct 1, 2013
Casey Payne Individual Corporate Director Feb 1, 2018
W-2 Managing Employee Feb 1, 2018
Keith Warfieldd Individual Corporate Director Oct 1, 2010
Gregory Moseley Individual Corporate Director Oct 1, 2010
Deloris Harris Individual Corporate Director Aug 30, 2017
Moses Thompson Individual Corporate Director Oct 1, 2010
Charles Henderson Individual Corporate Director Aug 30, 2017
Veda Horton Individual Corporate Director Aug 30, 2017
Karl Sykes Individual Corporate Director Aug 30, 2017

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
G a Carmichael Family Health Center, Inc.Carthage, MS, CCN 251143 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 26, 2021
G a Carmichael Family Health Center, IncGreenwood, MS, CCN 251158 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 26, 2021

Owned or controlled facilities with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1508922675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1668 W PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390465332",
            "telephone_number": "601-859-5213",
            "fax_number": "601-859-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 GRAND AVE",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "391942949",
            "telephone_number": "662-746-6532",
            "fax_number": "601-859-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G A CARMICHAEL FAMILY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-859-5213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09011452",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "251809",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yazoo City, MS

Sources for this page

Verify at the official NPI Registry.