NPIMap

Organization Active NPI

Echo Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Evansville, IN
National Provider Identifier
1700816683
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
261QF0400X Issued in IN
Legal business name
ECHO COMMUNITY HEALTH CARE, INC.
Practice address
501 John Street
Suite 12
Evansville, IN 47713-2705
Phone
(812) 436-0224
Fax
(812) 436-0230
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Authorized official

Name
Sandee E Strader-McMillen
Title
Chief Executive Officer
Phone
(812) 421-7489

Specialties & licenses 1

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

Addresses

Primary practice location

501 John Street
Suite 12
Evansville, IN 47713-2705

Mailing address

315 Mulberry St
Evansville, IN 47713-1252
Phone (812) 421-7489

Other identifiers 1

IdentifierTypeStateIssuer
200079040CMedicaidIN

Other names 1

  • ECHO Woodson John Street Health Care Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040721001319 IN Part B Supplier - Clinic/Group Practice 4981515145 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Evansville, IN
O20090914000396 IN Part A Provider - Federally Qualified Health Center (FQHC) 4981515145 Practice locations: Evansville, IN

Federally qualified health center certification: CCN 151820

Legal name
ECHO COMMUNITY HEALTH CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 25, 2000
Last certification
Jul 25, 2000
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 18, 1989 in IN
Enrollment address
401 John St
Evansville, IN 47713-2733
Related CCNs
151817

Federally qualified health center certification: CCN 151813

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY HEALTH CENTER OF EVANSVILLE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1993
Last certification
Oct 1, 1993
Ownership / control type
For profit – corporation
Most recent change of ownership
Feb 23, 1998 (1 total)
Facility address
501 John Street Ste 12
Evansville, IN 47713

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Echo Community Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

25 W Division St
Evansville, IN 47710
Phone (812) 436-0205

401 John St
Evansville, IN 47713
Phone (812) 436-0224

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Mike Cameron Individual Corporate DirectorBoard Member Jan 1, 2013
Aleise Barron Individual Corporate DirectorBoard Member Apr 18, 2023
Robert Royer Individual Corporate DirectorBoard Member Oct 22, 2009
Brad Gant Individual Corporate DirectorBoard Member Apr 18, 2023
Sandee Strader McMillen Individual Corporate OfficerCeo May 21, 2007
Myers Hyman Individual Corporate DirectorBoard Member Aug 3, 2012
Jason Emmerson Individual Corporate DirectorBoard Member Jan 1, 2019
Gerald Arnold Individual Corporate DirectorBoard Member Jan 1, 2009
Zachary Ward Individual Corporate DirectorBoard Member Sep 21, 2021
Alan G Swartz Individual Corporate OfficerCoo Oct 1, 2024
W-2 Managing EmployeeCoo Oct 1, 2024
Cindy L Shea Individual Corporate OfficerCfo Jul 18, 2011
W-2 Managing EmployeeCfo Jul 18, 2011
Lula Porter Individual Corporate DirectorBoard Member Jan 1, 2009
Jennifer Arnold Individual Corporate DirectorBoard Member Jul 2, 2022
Andrew Schenk Individual Corporate DirectorBoard Member Jan 18, 2024

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1700816683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131252",
            "telephone_number": "812-421-7489",
            "fax_number": "812-421-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 JOHN STREET",
            "address_2": "SUITE 12",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477132705",
            "telephone_number": "812-436-0224",
            "fax_number": "812-436-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECHO COMMUNITY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "STRADER-MCMILLEN",
        "authorized_official_first_name": "SANDEE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "812-421-7489"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IN",
            "license": "261QF0400X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200079040C",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECHO Woodson John Street Health Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.