NPIMap

Organization Active NPI

Baldwin Family Health Care

  • Federally Qualified Health Center (FQHC)
  • White Cloud, MI
National Provider Identifier
1790067338
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BALDWIN FAMILY HEALTH CARE
Practice address
555 E Wilcox Ave
White Cloud, MI 49349
Phone
(231) 689-3268
Fax
(231) 689-1030
NPI assigned
Sep 9, 2011
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BALDWIN FAMILY HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Julie Tatko
Title
Ceo
Phone
(231) 745-2743

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Student Health Clinic/Center 261QS1000X NU

Addresses

Primary practice location

555 E Wilcox Ave
White Cloud, MI 49349

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 689-3268

Other identifiers 2

IdentifierTypeStateIssuer
BPS-H80-010523OtherFQHC SITE ID
0D36000OtherBLUE CROSS GROUP

Other names 1

  • Child and Adolescent Health Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121009000646 MI Part A Provider - Federally Qualified Health Center (FQHC) 1153215413 Practice locations: White Cloud, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790067338. Details of each certification follow.

Federally qualified health center certification: CCN 231985

Legal name
BALDWIN FAMILY HEALTH CARE
Doing business as
BALDWIN FAMILY HEALTH CARE INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 16, 2012
Last certification
Oct 16, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 1975 in MI
Enrollment address
555 E Wilcox Ave
White Cloud, MI 49349-7512

Other NPIs with the same Medicare PAC ID 18

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

View all 18

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
23D1100615Family Health Care555 E Wilcox, White Cloud, MI 49349Certificate of waiverJun 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Baldwin Family Hlthcare23 organizations share this tax ID, including this one
Part of
Baldwin Family Hlthcare

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Pamela Panetta Individual Corporate DirectorSecretary Oct 1, 2018
Amber Durst Individual Corporate DirectorBoard Member Jul 1, 2021
Ashley Hawkins Individual Corporate DirectorBoard Member Jan 23, 2023
Susan Olds Individual Corporate DirectorBoard Member Jul 25, 2019
Mary Martin Individual Corporate DirectorBoard Member Jul 25, 2022
Corey Vanfleet Individual Corporate DirectorBoard Member May 1, 1996
Robert Fisher Individual Corporate DirectorChairman Apr 1, 1992
Eric Davidson Individual Corporate DirectorVice Chair Sep 1, 1986
Julie Tatko Individual Corporate DirectorCeo Sep 1, 2020
W-2 Managing EmployeeCeo Sep 1, 2020
Mason Husby Individual Corporate OfficerVice President & Cfo Apr 1, 2018
Marissa Kelly Individual Corporate DirectorBoard Member Dec 1, 2021
Bruce Whitney Individual Corporate DirectorTreasurer Jan 23, 2014

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1790067338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-689-3268",
            "fax_number": "231-876-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E WILCOX AVE",
            "city": "WHITE CLOUD",
            "state": "MI",
            "postal_code": "49349",
            "telephone_number": "231-689-3268",
            "fax_number": "231-689-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALDWIN FAMILY HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BALDWIN FAMILY HEALTH CARE",
        "enumeration_date": "2011-09-09",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "TATKO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-745-2743"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FQHC SITE ID",
            "identifier": "BPS-H80-010523",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "0D36000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child and Adolescent Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in White Cloud, MI

Sources for this page

Verify at the official NPI Registry.