East Jordan Family Health Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010666 Issued in MI

Legal business name

EAST JORDAN FAMILY HEALTH CENTER

Practice address

4955 S M 88 Hwy
Bellaire, MI 49615-9082

Phone

(231) 533-6655

Fax

(231) 533-5331

NPI assigned

Mar 12, 2015

Organization subpart

No

Name

Daniel McKinnon

Title

Ceo

Phone

(231) 536-2206

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

• East Jordan Family Health Center

  • Community/Retail Pharmacy
  • East Jordan, MI
  • NPI 1326038688
  NPD tax ID
• East Jordan Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Bellaire, MI
  • NPI 1376750091
  NPD tax ID
• East Jordan Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • East Jordan, MI
  • NPI 1366708257
  NPD tax ID

Tax ID family

Bellaire Family Health Center (4 organizations share this tax ID)

• Bellaire Family Health Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 22, 2025.

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1669865838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BRIDGE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279383",
            "telephone_number": "231-536-2206",
            "fax_number": "231-536-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S M 88 HWY",
            "city": "BELLAIRE",
            "state": "MI",
            "postal_code": "496159082",
            "telephone_number": "231-533-6655",
            "fax_number": "231-533-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST JORDAN FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-12",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669865838",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149742",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellaire Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Carpenter, ATC
• Hailey Casillas, LLMS
• Benjamin Riley Comment, PHARMD
• Ryan Demarsh, LPC
• East Jordan Family Health Center
• Autumn Michelle Fernandez, RN BSN
• William Tyrous French, LMSW
• Rebecca Helen Gamble
• Jeffrey Hart Green, MD
• Carl Thomas Heldt

• All providers in Bellaire, MI
• Community/Retail Pharmacy 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.