NPIMap

Organization Active NPI

Catherine's Health Center

Doing business as Catherine's Health Center - Mel Trotter

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
National Provider Identifier
1619740305
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CATHERINE'S HEALTH CENTER
Doing business as
Catherine's Health Center - Mel Trotter
Practice address
225 Commerce Ave SW
Grand Rapids, MI 49503-4107
Phone
(616) 336-8800
NPI assigned
Nov 3, 2023
Last updated
Nov 3, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CATHERINE'S HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Sara Brooks
Title
Operations Director
Phone
(616) 336-8800

Specialties & licenses 1

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

Addresses

Primary practice location

225 Commerce Ave SW
Grand Rapids, MI 49503-4107

Mailing address

950 36TH St SW
Wyoming, MI 49509-3587

Other names 1

  • Catherine's Health Center - Mel Trotter Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140520000626 MI Part B Supplier - Clinic/Group Practice 2860615838 Receives reassigned benefits from 20 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wyoming, MI; Grand Rapids, MI
O20231122000887 MI Part A Provider - Federally Qualified Health Center (FQHC) 2860615838 Practice locations: Grand Rapids, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619740305. Details of each certification follow.

Federally qualified health center certification: CCN C71009

Legal name
CATHERINE'S HEALTH CENTER
Doing business as
CATHERINE'S HEALTH CENTER - MEL TROTTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 21, 2023
Last certification
Nov 21, 2023
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Aug 11, 2005 in MI
Enrollment address
225 Commerce Ave SW
Grand Rapids, MI 49503-4107

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2291593Catherine's Health Center - Mel Trotter225 Commerce Avenue SW, Grand Rapids, MI 49503Provider-performed microscopyOct 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Catherine's Health Center13 organizations share this tax ID, including this one
Part of
Catherine's Health Center

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jacqueline Denhof Individual Corporate OfficerSecretary Jan 1, 2023
Kenneth S Johnson Individual Corporate Officer Jan 1, 2023
Andrea Inostroza Individual Corporate Director Jan 1, 2024
Yvonne George Individual Corporate Officer Jan 1, 2023
Sara Brooks Individual Corporate DirectorDirector of Operations Oct 4, 2021
Dustin Maynes Individual Corporate DirectorFinance Director Jan 1, 2021
Catherine's Health Center Organization, Wyoming, MI Non-profit Operational/Managerial Control Nov 8, 2023 100%
Adrienne Goodstal Individual Corporate Officer Jan 1, 2023
Allison Shook Individual Corporate DirectorDevelopment Director Jan 1, 2022
Cole Sweda Individual Corporate Director Jan 1, 2024
Catherine Kelly Individual Corporate Officer Jan 1, 2023
Nick Kokx Individual Corporate Officer Jan 1, 2023
Megan Erskine Individual Corporate OfficerCeo Apr 12, 2022 100%
W-2 Managing Employee Apr 12, 2022 100%
Mark a Contreras Individual Corporate DirectorMedical Director Jan 1, 2021
William Williams Individual Corporate Officer Jan 1, 2023
Michele L Zomer Individual Corporate OfficerPresident Jan 1, 2023
Andrea Cosier Individual Corporate Officer Jan 1, 2023
Alisha Davis Individual Corporate Officer Jan 1, 2023
Rick Schuitema Individual Corporate OfficerTreasurer Jan 1, 2024

Owners & managing parties with NPI records 15

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

View all 15

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Catherine's Health Dental CenterGrand Rapids, MI, CCN 231163 Federally qualified health center Operational/Managerial Control (100%) Aug 11, 2005
Catherine's Health Center - CrossroadsGrand Rapids, MI, CCN C71013 Federally qualified health center Operational/Managerial Control (100%) Dec 29, 2023

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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": "1698969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1619740305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 36TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495093587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 COMMERCE AVE SW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034107",
            "telephone_number": "616-336-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHERINE'S HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CATHERINE'S HEALTH CENTER",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "616-336-8800"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catherine's Health Center - Mel Trotter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.