NPIMap

Organization Active NPI

Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Dearborn, MI
National Provider Identifier
1649820986
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WESTERN WAYNE FAMILY HEALTH CENTERS
Practice address
4700 Schaefer Rd
Dearborn, MI 48126-3655
Phone
(313) 561-5100
NPI assigned
Sep 18, 2019
Last updated
Sep 18, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
WESTERN WAYNE FAMILY HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Authorized official

Name
Ms. Linda R Atkins, RN
Title
Ceo
Phone
(313) 561-5100

Specialties & licenses 1

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

Addresses

Primary practice location

4700 Schaefer Rd
Dearborn, MI 48126-3655

Mailing address

2700 Hamlin Blvd
Inkster, MI 48141-2206
Phone (313) 561-5100

Other names 1

  • Western Wayne Family Health Center, Dearborn Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060926000287 MI Part B Supplier - Clinic/Group Practice 4082617998 Receives reassigned benefits from 43 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dearborn, MI; Ecorse, MI; Inkster, MI; Lincoln Park, MI; Taylor, MI
O20191209001264 MI Part A Provider - Federally Qualified Health Center (FQHC) 4082617998 Practice locations: Dearborn, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649820986. Details of each certification follow.

Federally qualified health center certification: CCN 231150

Legal name
WESTERN WAYNE FAMILY HEALTH CENTERS
Doing business as
WESTERN WAYNE FAMILY HEALTH CENTER DEARBORN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 9, 2019
Last certification
Dec 9, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4700 Schaefer Rd
Dearborn, MI 48126-3655

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Western Wayne FH Centers7 organizations share this tax ID, including this one
Part of
Western Wayne FH Centers

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Saif Alsenad Individual Corporate Director Oct 1, 2023
Melissa Stellini Individual Corporate DirectorSecretary Dec 1, 2018
Walter Starghill Individual Corporate DirectorChairman Apr 21, 2011
Linda Atkins Individual Corporate Director Nov 18, 2008
W-2 Managing EmployeeCeo Nov 18, 2008
Arnold Gregory Individual Corporate Director Aug 1, 2022
Yolanda Lockett Individual Corporate Director Jan 24, 2025
Holly Mullins Individual Corporate Director Jan 24, 2025
William Miller Individual Corporate DirectorTreasurer Sep 1, 2014
Velma Jean Overman Individual Corporate DirectorVice Chairperson Mar 1, 2013
Carlotta Mitchell Individual Corporate Director Nov 21, 2023

Practitioners & affiliated clinicians

Practitioners 5

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": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1649820986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 HAMLIN BLVD",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481412206",
            "telephone_number": "313-561-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263655",
            "telephone_number": "313-561-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WAYNE FAMILY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN WAYNE FAMILY HEALTH CENTERS",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "ATKINS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-561-5100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "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": "Western Wayne Family Health Center, Dearborn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.