East Jordan Family Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

EAST JORDAN FAMILY HEALTH CENTER

Doing business as

Central Lake Family Health Center

Practice address

7960 W. Old State Road
Central Lake, MI 49622

Phone

(231) 544-3700

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Daniel McKinnon

Title

Ceo

Phone

(231) 536-2206

Specialties & licenses 1

Addresses

Other names 1

• Central Lake Family Health Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Federally qualified health center certification: CCN 231900

Legal name

CENTRAL LAKE FAMILY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jun 1, 2004

Last certification

Jun 1, 2004

Ownership / control type

For profit – partnership

Facility address

7960 West Old State St
Central Lake, MI 49622

Other NPIs on the same Medicare enrollment 2

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

• East Jordan Family Health Center

  • Federally Qualified Health Center (FQHC)
  • East Jordan, MI
  • NPI 1114958691

  O20040210000099

  Same enrollment
• East Jordan Family Health Center

  dba Bellaire Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Bellaire, MI
  • NPI 1376750091

  O20040210000099

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Priyanka A Patel, M.D.

  • Psychiatry Physician
  • Decatur, GA
  • NPI 1902098197
  NPD

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1669680187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 W OLD STATE RD",
            "city": "CENTRAL LAKE",
            "state": "MI",
            "postal_code": "496225149",
            "telephone_number": "231-544-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 W. OLD STATE ROAD",
            "city": "CENTRAL LAKE",
            "state": "MI",
            "postal_code": "49622",
            "telephone_number": "231-544-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST JORDAN FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "MCKINNON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-536-2206"
    },
    "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": "Central Lake Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Boggs, RDN
• Central Lake Pharmacy Inc (Central Lake Pharmacy)
• Duane L Chappuies
• David Dibble DDS PC
• David Lee Dibble, DDS
• Eastport Village Care Home LLC
• Karen Adkins Ferguson, RPH
• Kim Edward Forster, R.PH
• Andrea Kline, CADC. CPRC
• Briana Marie Padgett, PSY S

• Federally Qualified Health Center (FQHC) in Central Lake, MI
• Providers in Central Lake, MI by specialty
• Federally Qualified Health Center (FQHC) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.