NPIMap

Organization Active NPI

Upper Great Lakes Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Gwinn, MI
National Provider Identifier
1700103777
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Practice address
301 Explorer Street
Gwinn, MI 49841-2813
Phone
(906) 346-4924
Fax
(906) 372-3230
NPI assigned
Apr 29, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Trevor Hodges
Title
Ceo
Phone
(906) 483-1846

Other NPIs on the same Medicare enrollment 10

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

Other NPIs with the same Medicare PAC ID 11

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

Practitioners 91

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

View all 91

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100629000853 MI Part B Supplier - Clinic/Group Practice 1951432384 Receives reassigned benefits from 63 practitioners
10 other NPIs on this enrollment
Practice locations: Menominee, MI; Marquette, MI; Gwinn, MI; Iron River, MI; East Lansing, MI; Calumet, MI; Hancock, MI
O20110418000732 MI Part a Provider - Federally Qualified Health Center (FQHC) 1951432384 Practice locations: Gwinn, MI

Federally qualified health center certification: CCN 231955

Medicare enrollment files
Legal name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Doing business as
KI SAWYER FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 20, 2011
Last certification
Apr 20, 2011
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2013 in MI
Enrollment address
301 Explorer St
Gwinn, MI 49841-2813

All disclosed owners & managing parties 12

Medicare enrollment files

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

NameRoleSinceShare
Tanya Johnson Individual Corporate Officer Oct 28, 2020
Trevor Hodges Individual Corporate DirectorCfo Jan 1, 2020
W-2 Managing EmployeeCfo Jan 1, 2020
Mark Rouleau Individual Corporate Officer Nov 24, 2021
Stephen Vairo Individual Corporate Officer Oct 7, 2009
Donald Simila Individual Corporate DirectorCeo Dec 1, 2010
W-2 Managing EmployeeCeo Dec 1, 2010
Kevin L Piggott Individual Corporate Officer Oct 31, 2018
Cathryn Beer Individual Corporate Officer Oct 26, 2016
Dianna Christenson Individual Corporate OfficerBoard Member Dec 4, 2013
Christopher Adams Individual Corporate Officer Jun 26, 2019
Julie Shaw Individual Corporate Officer Sep 25, 2019
Allen Mott Individual Corporate Officer Mar 28, 2018
Micah Stipech Individual Corporate Officer Mar 25, 2020

National Provider Directory

National Provider Directory
Tax ID family
Upper Great Lakes Center18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

56901 S 6th St
Ste Ab
Calumet, MI 49913

500 Campus Dr
Ste 2
Hancock, MI 49930
Phone (906) 483-1060

500 Campus Dr
Ste 4
Hancock, MI 49930
Phone (906) 483-1730

1603 Gundlach Rd
Houghton, MI 49931

1110 10th Ave
Menominee, MI 49858
Phone (906) 290-5000

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X MI Primary

Addresses

NPPES NPI Registry

Primary practice location

301 Explorer Street
Gwinn, MI 49841-2813

Mailing address

135 E M35
Gwinn, MI 49841-9160
Phone (906) 346-4924

Other names 1

NPPES NPI Registry
  • Sawyer Family Health Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2026.

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1700103777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E M35",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498419160",
            "telephone_number": "906-346-4924",
            "fax_number": "906-372-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EXPLORER STREET",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498412813",
            "telephone_number": "906-346-4924",
            "fax_number": "906-372-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER GREAT LAKES FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "906-483-1846",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sawyer Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sawyer Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gwinn, MI

Sources for this page

Verify at the official NPI Registry.