NPIMap

Organization Active NPI

Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Twisp, WA
National Provider Identifier
1679962401
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTERS
Practice address
541 W. Second Avenue
Twisp, WA 98856
Phone
(509) 422-5700
NPI assigned
Jan 16, 2015
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Jesus Hernandez
Title
Ceo
Phone
(509) 422-5700

Specialties & licenses 1

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

Addresses

Primary practice location

541 W. Second Avenue
Twisp, WA 98856

Mailing address

PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-5700

Other names 1

  • Family Health Centers Twisp Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150603000821 WA Part A Provider - Federally Qualified Health Center (FQHC) 9739076217 Practice locations: Twisp, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679962401. Details of each certification follow.

Federally qualified health center certification: CCN 941000

Legal name
FAMILY HEALTH CENTERS
Doing business as
FAMILY HEALTH CENTERS TWISP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 30, 2015
Last certification
May 30, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 1985 in WA
Enrollment address
541 W 2ND Ave
Twisp, WA 98856-9863

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2309889Family Health Centers541 W 2ND St, Twisp, WA 98856Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Family Health Centers23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

106 S Whitcomb Ave
Tonasket, WA 98855
Phone (509) 486-0114

18 Twin Lakes Rd
Winthrop, WA 98862
Phone (509) 996-2186

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Michelle Sandoval Individual Corporate DirectorBoard Member Mar 14, 2021
Charlene a Burns Individual Corporate DirectorBoard Member Apr 9, 2019
Scott Matlock Individual Corporate Officer Jul 17, 2020
W-2 Managing EmployeeCfo Jul 17, 2020
Melodie White Individual Corporate Officer Oct 8, 2012
W-2 Managing EmployeeCoo Oct 8, 2012
Teresa Trejo Individual Corporate DirectorBoard Member May 9, 2017
Jose Luna Individual Corporate DirectorBoard Member Jun 12, 2018
Jesus Hernandez Individual 5% Or Greater Direct Ownership Interest Mar 14, 2016
Corporate Officer Mar 14, 2016
W-2 Managing EmployeeCeo Mar 14, 2016
Roni Holder-Diefenbach Individual Corporate DirectorBoard Member Sep 10, 2019
Joan Wellman Individual Corporate DirectorBoard Member Jan 12, 2021
Peter Morgan Individual Corporate DirectorBoard Member Jun 1, 2011
Family Health Centers Organization, Okanogan, WA Non-profit 5% Or Greater Direct Ownership Interest May 1, 2015 100%
Operational/Managerial Control May 1, 2015 100%

Owners & managing parties with NPI records 5

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

  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Tonasket, WA
    • NPI 1184883449

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Omak, WA
    • NPI 1306005715

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Bridgeport, WA
    • NPI 1497176390

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Okanogan, WA
    • NPI 1609804392

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Brewster, WA
    • NPI 1629237482

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Family Health CentersBridgeport, WA, CCN 501968 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2014
Jan 1, 2014

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Family Health Centers
    • Federally Qualified Health Center (FQHC)
    • Bridgeport, WA
    • NPI 1497176390

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1679962401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 W. SECOND AVENUE",
            "city": "TWISP",
            "state": "WA",
            "postal_code": "98856",
            "telephone_number": "509-422-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-422-5700"
    },
    "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": "Family Health Centers Twisp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Twisp, WA

Sources for this page

Verify at the official NPI Registry.