NPIMap

Organization Active NPI

Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Brewster, WA
National Provider Identifier
1821340092
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
600625131 Issued in WA
Legal business name
FAMILY HEALTH CENTERS
Practice address
520 W Indian Ave
Brewster, WA 98812
Phone
(509) 422-5700
Fax
(509) 422-7680
NPI assigned
Oct 11, 2012
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Jesus Hernandez
Title
Ceo
Phone
(509) 422-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 600625131 WA Primary

Addresses

Primary practice location

520 W Indian Ave
Brewster, WA 98812

Mailing address

PO Box 1340
Okanogan, WA 98840
Phone (509) 422-5700

Other identifiers 1

IdentifierTypeStateIssuer
501949OtherWAMEDICARE/OSCAR CERTIFICATION

Other names 1

  • Brewster Medical Clinic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000378 WA Part B Supplier - Clinic/Group Practice 9739076217 Receives reassigned benefits from 52 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bridgeport, WA; Winthrop, WA; Twisp, WA; Tonasket, WA; Omak, WA; Okanogan, WA; Brewster, WA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Family Health Centers

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1821340092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "98840",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W INDIAN AVE",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "98812",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH CENTERS",
        "enumeration_date": "2012-10-11",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-422-5700"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "WA",
            "license": "600625131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE/OSCAR CERTIFICATION",
            "identifier": "501949",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brewster Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brewster, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.