NPIMap

Organization Active NPI

Family Health Center, Inc

  • Clinic/Center
  • Laurel, MS
National Provider Identifier
1760488357
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FAMILY HEALTH CENTER, INC
Practice address
117 South 11TH Avenue
Laurel, MS 39441-4361
Phone
(601) 425-3033
Fax
(601) 422-0431
NPI assigned
Jun 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Rashad N. Ali, M.D., J.D., FAGOGNPI 1649297201
Title
Executive Director
Phone
(601) 425-3033

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
Clinic/Center 261Q00000X MS Primary

Addresses

Primary practice location

117 South 11TH Avenue
Laurel, MS 39441-4361

Mailing address

P.O. Box 4361
Laurel, MS 39440
Phone (601) 425-3033

Other identifiers 2

IdentifierTypeStateIssuer
9010072MedicaidMS
09010072MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040414000267 MS Part B Supplier - Clinic/Group Practice 9638163348 Receives reassigned benefits from 22 practitioners
4 other NPIs on this enrollment
Practice locations: Laurel, MS; Sandersville, MS; Taylorsville, MS; Waynesboro, MS
O20081125000766 MS Part A Provider - Federally Qualified Health Center (FQHC) 9638163348 Practice locations: Laurel, MS

Federally qualified health center certification: CCN 251835

Legal name
FAMILY HEALTH CENTER, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1992
Last certification
Jul 1, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1986 in MS
Enrollment address
117S 11TH Ave
Laurel, MS 39440-4312

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 4

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

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

531 Highway 28 E
Taylorsville, MS 39168
Phone (601) 785-9580

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
George Barnes Individual Corporate Director Oct 31, 2008 1%
Kathryn Mizell Individual Corporate Director Oct 31, 2008
Randy Laird Individual Corporate Director Oct 31, 2008
Barbara Pruitt Individual Corporate Director Oct 31, 2008
Rhonda Rowzee Individual Corporate Director Oct 31, 2008
Coney Lee Johnson Individual Corporate OfficerCoo Apr 1, 2012
W-2 Managing EmployeeCoo Apr 1, 2012
Rashad N Ali Individual Corporate OfficerCeo Aug 1, 2006 0.05%
W-2 Managing EmployeeCeo Aug 1, 2006
Joan Young Individual Corporate Director Oct 31, 2008
Trina Heidelberg Individual Corporate Director Oct 31, 2008
Lee Farmer Individual Corporate Director Dec 3, 2008

Owners & managing parties with NPI records 1

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

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 Center, Inc.Waynesboro, MS, CCN 251067 Federally qualified health center Other Aug 16, 1986

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760488357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4361",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-425-3033",
            "fax_number": "601-422-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SOUTH 11TH AVENUE",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394414361",
            "telephone_number": "601-425-3033",
            "fax_number": "601-422-0431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "RASHAD",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "601-425-3033",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D., J.D., FAGOG"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9010072",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09010072",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.