NPIMap

Organization Active NPI

Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Okanogan, WA
National Provider Identifier
1609804392
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
600625131 Issued in WA
Legal business name
FAMILY HEALTH CENTERS
Practice address
716 First Avenue South
Okanogan, WA 98840-9679
Phone
(509) 422-5700
Fax
(509) 422-7680
NPI assigned
Jun 29, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Mr. Jesus Hernandez
Title
Interm Ceo
Phone
(509) 422-7601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 600625131 WA Primary

Addresses

Primary practice location

716 First Avenue South
Okanogan, WA 98840-9679

Mailing address

PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-5700

Other identifiers 14

IdentifierTypeStateIssuer
501837OtherWAPTAN
C03341OtherWAMEDICARE PTAN
801838OtherWAPTAN
1609804392OtherWAMEDICARE
7060643MedicaidWA
1821340092OtherWAMEDICARE
1184883449OtherWAMEDICARE
501836OtherWAPTAN
G000354600OtherWAMEDICARE PTAN
501949OtherWAMEDICARE PTAN
1306005715OtherWAMEDICARE
501968OtherWAMEDICARE PTAN
1497176390OtherWAMEDICARE
1629237482OtherWAMEDICARE

Other names 1

  • OKANOGAN FARM WORKERS CLINIC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000378 WA Part B Supplier - Clinic/Group Practice 9739076217 Receives reassigned benefits from 52 practitioners
1 other NPI on this enrollment
Practice locations: Bridgeport, WA; Winthrop, WA; Twisp, WA; Tonasket, WA; Omak, WA; Okanogan, WA; Brewster, WA

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1015 Columbia Ave
Bridgeport, WA 98813
Phone (509) 686-0603

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Family Health CentersBridgeport, WA, CCN 501968 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014
Family Health Centers TwispTwisp, WA, CCN 941000 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 May 1, 2015
May 1, 2015

Owned or controlled facilities with NPI records 2

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

  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Bridgeport, WA
    • NPI 1497176390

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Twisp, WA
    • NPI 1679962401

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 89

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 89

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1609804392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 FIRST AVENUE SOUTH",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988409679",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "INTERM CEO",
        "authorized_official_telephone_number": "509-422-7601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600625131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "501837",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C03341",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "801838",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1609804392",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7060643",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1821340092",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1184883449",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "501836",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G000354600",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "501949",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1306005715",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "501968",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1497176390",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1629237482",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OKANOGAN FARM WORKERS CLINIC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Okanogan, WA

Sources for this page

Verify at the official NPI Registry.