NPIMap

Organization Active NPI

Family Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
National Provider Identifier
1811065576
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY HEALTH CENTER INC
Practice address
117 W Paterson Street
Kalamazoo, MI 49007-2557
Phone
(269) 349-2641
Fax
(269) 488-8101
NPI assigned
Dec 1, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Ms. Denise R Crawford
Title
President and Ceo
Phone
(269) 349-4257

Specialties & licenses 1

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

Addresses

Primary practice location

117 W Paterson Street
Kalamazoo, MI 49007-2557

Mailing address

117 W Paterson Street
Kalamazoo, MI 49007-2557
Phone (269) 349-2641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040510000899 MI Part B Supplier - Clinic/Group Practice 1759370216 Receives reassigned benefits from 133 practitioners
9 other NPIs on this enrollment
Practice locations: Kalamazoo, MI
O20080826000006 MI Part A Provider - Federally Qualified Health Center (FQHC) 1759370216 Practice locations: Kalamazoo, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811065576. Details of each certification follow.

Federally qualified health center certification: CCN 231837

Legal name
FAMILY HEALTH CENTER, INC.
Doing business as
FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1994
Last certification
Jan 1, 1994
Ownership / control type
For profit – partnership
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1971 in MI
Enrollment address
117 W Paterson St
Kalamazoo, MI 49007-2557

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 9

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

National Provider Directory

National Provider Directory

Locations

2918 Portage St
Kalamazoo, MI 49001

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Denise R Crawford Individual Corporate OfficerChief Executive Officer Feb 23, 2009
W-2 Managing EmployeeChief Executive Officer Feb 23, 2009
Sherrie Yvonne Fuller Individual Corporate OfficerBoard Chairperson Oct 1, 2013
Eleanor J Harris Individual Corporate OfficerBoard Member Jul 1, 2020
Efeosa Idemudia Individual Corporate OfficerBoard Member Jan 1, 2019
Terryse Brown Individual Corporate OfficerBoard Member Jan 1, 2013
Jacqueline Marie Luttrell Individual Corporate OfficerBoard Member Jan 1, 2015
Aaron Lane-Davies Individual Corporate OfficerBoard Member Aug 1, 2019
Patrick Allen Troman Individual Corporate OfficerBoard Treasurer Mar 1, 2019
Eileen Chiang Individual W-2 Managing EmployeeChief Financial Officer Feb 15, 2010
Cathy Ash Individual Corporate OfficerCo Vice President Jan 1, 2016
Christine Beverly Individual Corporate OfficerBoard Member Oct 1, 2020
Ollie Chambers Individual Corporate OfficerBoard Secretary Jan 1, 2008
Roberto Flachier Individual Corporate OfficerBoard Member Jan 1, 2018

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 142

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 142

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1811065576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON STREET",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641",
            "fax_number": "269-488-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W PATERSON STREET",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557",
            "telephone_number": "269-349-2641",
            "fax_number": "269-488-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "269-349-4257",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.