NPIMap

Organization Active NPI

219 Health Network, Inc.

Doing business as 219 Health Network

  • Federally Qualified Health Center (FQHC)
  • East Chicago, IN
National Provider Identifier
1790679033
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
219 HEALTH NETWORK, INC.
Doing business as
219 Health Network
Practice address
4320 Fir St
Unit 210
East Chicago, IN 46312-8410
Phone
(219) 392-7670
Fax
(219) 392-7491
NPI assigned
Jun 3, 2025
Last updated
Jun 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Authorized official

Name
William Cortes
Title
Executive Director
Phone
(219) 703-2585

Specialties & licenses 1

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

Addresses

Primary practice location

4320 Fir St
Unit 210
East Chicago, IN 46312-8410

Mailing address

100 W Chicago Ave Ste F
East Chicago, IN 46312-3261
Phone (219) 392-7016

Other names 1

  • 219 Health Network Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250919002813 IN Part A Provider - Federally Qualified Health Center (FQHC) 0547521452 Practice locations: East Chicago, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790679033. Details of each certification follow.

Federally qualified health center certification: CCN C51106

Legal name
219 HEALTH NETWORK INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 11, 2025
Last certification
Sep 11, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4320 Fir St
Unit 210
East Chicago, IN 46312-8410

National Provider Directory

National Provider Directory
Tax ID family
219 Health Network Inc39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

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
Luis Molina Individual Corporate Director Jul 25, 2018
William Cortes Individual Corporate DirectorExecutive Director Apr 28, 2024
W-2 Managing EmployeeExecutive Director Apr 28, 2024
Gloria Vela Individual Corporate Director Apr 9, 2018
Marjol Rush-Collet Individual Corporate Director Apr 9, 2018
Leo Correa Individual Corporate OfficerChairman Jul 25, 2018
Sandra Noe Individual Corporate Director Aug 30, 2023
Sava Pavkovich Individual Corporate Director Aug 30, 2023
Milton Reed Individual Corporate Director Apr 9, 2018
Sara Jiminez Individual Corporate Director Dec 18, 2018
Martha Gonzalez Individual Corporate Director Oct 26, 2022

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1790679033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CHICAGO AVE STE F",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123261",
            "telephone_number": "219-392-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 FIR ST",
            "address_2": "UNIT 210",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463128410",
            "telephone_number": "219-392-7670",
            "fax_number": "219-392-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "219 HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "CORTES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "219-703-2585"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "219 Health Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Chicago, IN

Sources for this page

Verify at the official NPI Registry.