NPIMap

Organization Active NPI

Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Fresno, CA
National Provider Identifier
1609384940
Registry record updated Oct 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTHCARE NETWORK
Practice address
255 N Herwaldt Dr
Fresno, CA 93701-2186
Phone
(559) 737-4700
Fax
(559) 734-1247
NPI assigned
Jan 22, 2018
Last updated
Oct 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2022

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

Authorized official

Name
Kerry Hydash
Title
President & Ceo
Phone
(559) 737-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

255 N Herwaldt Dr
Fresno, CA 93701-2186

Mailing address

305 E Center Ave
Visalia, CA 93291-6331
Phone (559) 737-4700

Other identifiers 1

IdentifierTypeStateIssuer
921088OtherCAMEDICARE ID-TYPE UNSPECIFIED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000681 CA Part B Supplier - Clinic/Group Practice 6305756339 Receives reassigned benefits from 429 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Reedley, CA; Ivanhoe, CA; Selma, CA; Springville, CA; Squaw Valley, CA; Strathmore, CA; Terra Bella, CA; Three Rivers, CA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609384940. Details of each certification follow.

  • CCN 921088 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 921088

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FAMILY HEALTHCARE NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 28, 2018
Last certification
Jun 28, 2018
Ownership / control type
For profit – corporation
Facility address
255 N Herwaldt Drive
Fresno, CA 93701

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666828800000",
    "number": "1609384940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CENTER AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932916331",
            "telephone_number": "559-737-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N HERWALDT DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937012186",
            "telephone_number": "559-737-4700",
            "fax_number": "559-734-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "HYDASH",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "559-737-4700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "921088",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.