NPIMap

Organization Active NPI

Henry J. Austin Health Center, Inc.

Doing business as Henry J. Austin Health Center at Oaks Integrated Care

  • Federally Qualified Health Center (FQHC)
  • Trenton, NJ
National Provider Identifier
1679945760
Registry record updated Oct 20, 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 at Oaks Integrated Care
Practice address
314-316 East State Street
Trenton, NJ 08608-1810
Phone
(609) 278-5900
Fax
(609) 392-4827
NPI assigned
Oct 28, 2015
Last updated
Oct 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

314-316 East State Street
Trenton, NJ 08608-1810

Mailing address

314-316 East State Street
Trenton, NJ 08608-1810
Phone (609) 278-5900

Other names 1

  • Henry J. Austin Health Center at Oaks Integrated Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181204002295 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 1679945760. Details of each certification follow.

Federally qualified health center certification: CCN 311942

Legal name
HENRY J AUSTIN HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 27, 2018
Last certification
Dec 27, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 19, 1986 in NJ
Enrollment address
314-316 East State Street
Trenton, NJ 86081810

Other NPIs with the same Medicare PAC ID 8

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

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

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 26

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 Corporate DirectorDirector of Information Apr 1, 2020
W-2 Managing EmployeeDirector of Information Apr 1, 2020
Sehrish Mazhar Individual Corporate DirectorDirector of Finance Aug 14, 2023
W-2 Managing EmployeeDirector of Finance Aug 14, 2023
Luz Godbold Individual OtherMember Feb 22, 2022
Poonam Kalaria Individual Corporate DirectorDirector of Pharmacy Aug 1, 2023
W-2 Managing EmployeeDirector of Pharmacy Sep 7, 2021
Merkle Cherry Individual Corporate DirectorChief Operating Officer Feb 20, 2019
W-2 Managing EmployeeChief Operating Officer Aug 20, 2018
Maryann Crawley Individual OtherBoard Treasure Feb 22, 2022
Juliette George Individual Corporate DirectorDirector of Quality May 8, 2023
W-2 Managing EmployeeDirector of Quality May 8, 2023
Nancy Perez Individual W-2 Managing EmployeeDelegated Official Dec 22, 2014
Rebeca Klege Individual Corporate DirectorDirector of Research Jul 19, 2021
W-2 Managing EmployeeDirector of Research Jul 19, 2021
Khyati Patel Individual Corporate DirectorDirector of Compliance Oct 17, 2022
W-2 Managing EmployeeDirector of Compliance Oct 17, 2022
George Preston Wilson Individual Other Feb 22, 2022
Beverly a Smith Individual Corporate DirectorChairperson Feb 26, 2013
Nora Brown Individual W-2 Managing EmployeeDirector of Patient Access Jun 7, 2022
Maria Santiago Individual Corporate DirectorDirector of HR Jan 28, 2019
W-2 Managing EmployeeDirector of HR Oct 23, 2017
Devin T Goodman Individual W-2 Managing EmployeeDental Director Apr 4, 2008
Emmanuel Bourjolly Individual OtherMember May 20, 2024
Rachael B Evans Individual Corporate OfficerChief Medical Officer Mar 31, 2017
W-2 Managing EmployeeChief Medical Officer Mar 31, 2017
Charles Ellis Individual OtherVice Chairman Jan 2, 2024
Kristina Flagg Individual Other Mar 6, 2024
Kerwin Garcia Individual Corporate DirectorDirector of Operations Mar 6, 2023
W-2 Managing EmployeeDirector of Operations Mar 6, 2023
Lee G Ruszczyk Individual W-2 Managing EmployeeBehavioral Health Director Dec 1, 2014
Jenny Fredericks Individual Corporate DirectorDirector of Communications Nov 28, 2022
W-2 Managing EmployeeDirector of Communications Nov 28, 2022
Avery Ince Individual OtherMember Feb 22, 2022
Elizabeth McNeil Individual OtherMember May 20, 2024
Lakeisha Cooper Individual Corporate DirectorDirector of Nursing Jul 31, 2020
W-2 Managing EmployeeDirector of Nursing Jul 31, 2020
Charles L Davis Individual Corporate OfficerChief Executive Officer May 6, 2024
Corporate DirectorChief Executive Officer May 6, 2024
W-2 Managing EmployeeChief Executive Officer 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.

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1679945760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314-316 EAST STATE STREET",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086081810",
            "telephone_number": "609-278-5900",
            "fax_number": "609-392-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314-316 EAST STATE STREET",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086081810",
            "telephone_number": "609-278-5900",
            "fax_number": "609-392-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY J. AUSTIN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "DAIVIS",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry J. Austin Health Center at Oaks Integrated Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.