NPIMap

Organization Active NPI

The Family Health Centers of Georgia, Inc

Doing business as The Family Health Center at West End

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
National Provider Identifier
1720080989
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
N/A Issued in GA
Legal business name
THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Doing business as
The Family Health Center at West End
Practice address
868 York Ave SW
Atlanta, GA 30310-2750
Phone
(404) 752-1400
Fax
(404) 756-8749
NPI assigned
Jun 1, 2005
Last updated
Feb 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Authorized official

Name
Dr. Michael W. Brooks, MDNPI 1174513089
Title
President, Ceo
Phone
(404) 752-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X N/A GA Primary

Addresses

Primary practice location

868 York Ave SW
Atlanta, GA 30310-2750

Mailing address

868 York Ave SW
Atlanta, GA 30310-2750
Phone (404) 752-1400

Other identifiers 1

IdentifierTypeStateIssuer
000437478AMedicaidGA

Other names 1

  • The Family Health Center at West End Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040413000807 GA Part B Supplier - Clinic/Group Practice 2062406903 Receives reassigned benefits from 38 practitioners
12 other NPIs on this enrollment
Practice locations: Rome, GA; Morrow, GA; Atlanta, GA; Marietta, GA; Douglasville, GA
O20100602000313 WI Part A Provider - Federally Qualified Health Center (FQHC) 2062406903 Practice locations: Atlanta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720080989. Details of each certification follow.

Federally qualified health center certification: CCN 111810

Legal name
THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 17, 1976 in GA
Enrollment address
868 York Ave SW
Atlanta, GA 30310-2750

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Stephanie Smith Individual Corporate Director Jan 1, 2014
Michael W Brooks Individual Corporate DirectorPresident, Ceo Jun 1, 2011
W-2 Managing EmployeePresident, Ceo Jun 1, 2011
Sulieman a Wazeerud Din Individual Corporate Director Jan 1, 2014
Jan J Williams Individual Corporate Director Jan 1, 2014
William Bledsoe Individual Corporate DirectorSr VP, Cfo Jun 1, 2011
Janice S Andrews Individual Corporate Director Jan 1, 2014
Bernita C Ransom Individual Corporate Director Jan 1, 2014
April W Nelson Individual Corporate Director Jan 1, 2014

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1720080989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 YORK AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102750",
            "telephone_number": "404-752-1400",
            "fax_number": "404-756-8749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 YORK AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102750",
            "telephone_number": "404-752-1400",
            "fax_number": "404-756-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY HEALTH CENTERS OF GEORGIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "404-752-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000437478A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Family Health Center at West End",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Family Health Center at West End",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.