NPIMap

Organization Active NPI

Henry J Austin Health Center, Inc.

Doing business as Henry J. Austin Health Center Mobile Health Unit

  • Federally Qualified Health Center (FQHC)
  • Trenton, NJ
National Provider Identifier
1639713068
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HENRY J AUSTIN HEALTH CENTER, INC.
Doing business as
Henry J. Austin Health Center Mobile Health Unit
Henry J. Austin Health Center. Inc
Practice address
218 N Broad St
Trenton, NJ 08608-1306
Phone
(609) 278-5900
Fax
(609) 695-3532
NPI assigned
Oct 29, 2019
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HENRY J AUSTIN HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Authorized official

Name
Charles L Davis II, AO
Title
Ceo
Phone
(609) 278-5970

Specialties & licenses 1

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

Addresses

Primary practice location

218 N Broad St
Trenton, NJ 08608-1306

Mailing address

321 N Warren St
Trenton, NJ 08618-4794
Phone (609) 278-5900

Other names 2

  • Henry J. Austin Health Center Mobile Health Unit Doing business as
  • Henry J. Austin Health Center. Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110602000626 NJ Part B Supplier - Clinic/Group Practice 9739179409 Receives reassigned benefits from 46 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Trenton, NJ
O20191223001426 NJ Part A Provider - Federally Qualified Health Center (FQHC) 9739179409 Practice locations: Trenton, NJ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639713068. Details of each certification follow.

Federally qualified health center certification: CCN 311946

Legal name
HENRY J AUSTIN HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 18, 2019
Last certification
Dec 18, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 19, 1986 in NJ
Enrollment address
218 N Broad St
Trenton, NJ 86081306

Other NPIs with the same Medicare PAC ID 8

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
Tax ID family
Henry J Austin Health Center at Family Guidance Center Corporation13 organizations share this tax ID, including this one
Part of
Henry J Austin Health Center at Family Guidance Center Corporation

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 14

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

NameRoleSinceShare
Drew Hopkins Individual W-2 Managing Employee Apr 1, 2020
Poonam Kalaria Individual W-2 Managing Employee Aug 1, 2023
Merkle Cherry Individual W-2 Managing EmployeeChief Operating Officer Feb 20, 2019
Nancy Perez Individual W-2 Managing EmployeeProvider Enrollment Credentialing Dec 28, 2014
Raza Gilsni Individual W-2 Managing Employee Sep 9, 2024
Beverly a Smith Individual Corporate DirectorVice Person Oct 18, 2019
Nora Brown Individual W-2 Managing EmployeeDirector of Access Mar 25, 2024
Maria Santiago Individual W-2 Managing Employee Jan 28, 2019
Devin T Goodman Individual W-2 Managing EmployeeDental Director Oct 18, 2019
Rachael B Evans Individual Corporate OfficerCmo Oct 18, 2019
W-2 Managing EmployeeCmo Oct 18, 2019
Operational/Managerial ControlCmo Oct 18, 2019
Lee G Ruszczyk Individual W-2 Managing EmployeeBehavioral Health Director Oct 18, 2019
Jenny Fredericks Individual W-2 Managing Employee Nov 28, 2022
Lakeisha Cooper Individual W-2 Managing EmployeeDirector of Nursing May 10, 2021
Charles L Davis Individual Corporate Officer May 6, 2024
Corporate Director May 6, 2024
W-2 Managing EmployeeChief Operating Officer May 6, 2024
Operational/Managerial Control May 6, 2024

Owners & managing parties with NPI records 3

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

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": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1639713068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N WARREN ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184794",
            "telephone_number": "609-278-5900",
            "fax_number": "609-396-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 N BROAD ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086081306",
            "telephone_number": "609-278-5900",
            "fax_number": "609-695-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY J AUSTIN HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENRY J AUSTIN HEALTH CENTER, INC.",
        "enumeration_date": "2019-10-29",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "609-278-5970",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "AO"
    },
    "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": "Henry J. Austin Health Center Mobile Health Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry J. Austin Health Center. Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.