Alcona Citizens for Health, Inc

Organization Active NPI Federally Qualified Health Center (FQHC) · Indian River, MI

NPI 1831567643 · NPPES record last updated Jan 12, 2026

Key facts

NPI
1831567643
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
ALCONA CITIZENS FOR HEALTH, INC
Practice address
6135 Cressy St
Indian River, MI 49749
Phone
(231) 238-8908
NPI assigned
Sep 10, 2015
Organization subpart
No

Authorized official

Name
Nancy Spencer
Title
Ceo
Phone
(989) 358-0673

Other NPIs with the same Medicare PAC ID 15

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

Corporate family (same tax ID) 41

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

View all 41

Practitioners 65

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

View all 65

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Federally qualified health center certification: CCN 231082

Legal name
ALCONA CITIZENS FOR HEALTH INC
Doing business as
INDIAN RIVER MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 12, 2015
Last certification
Nov 12, 2015
Ownership / control type
For profit – partnership
Organization structure
Corporation · Non-profit
Incorporated
Jul 19, 1972 in MI
Enrollment address
6135 Cressy St
Indian River, MI 49749-5151

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Teri Johnson
Individual
Corporate Officer
Board Member
May 20, 2021
Shelley Chamberlain
Individual
Corporate Officer
Board Member
Apr 14, 2016
Joseph P Garber
Individual
Corporate Officer
Board Member
Oct 1, 2015
Carol E Lund
Individual
Corporate Officer
Board Member
Oct 1, 2015
Nancy Spencer
Individual
Contracted Managing Employee
Ceo
Jan 1, 2018 100%
Corporate Director
Ceo
Jan 1, 2018 100%
Deborah Miller
Individual
Corporate Officer
Board Member
Feb 16, 2017
Carolyn N Brummund
Individual
Corporate Officer
Board Member
Oct 1, 2015
Joseph a Plunkey
Individual
Corporate Officer
Board Member
Oct 1, 2015
Stephanie Ann Dettloff
Individual
Corporate Officer
Board Member
Jan 1, 2019
Richard B Sangster
Individual
Corporate Officer
Board Member
Feb 16, 2017
Charles Sherwin
Individual
Corporate Officer
Board Member
Oct 1, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151106000446 MI Part a Provider - Federally Qualified Health Center (FQHC) 5991691958 Practice locations: Indian River, MI

National Provider Directory

Tax ID family
Alcona Health Ctr (42 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

6135 Cressy St
Indian River, MI 49749

Mailing address

6135 Cressy St
Indian River, MI 49749-5151
Phone (231) 238-8908

Other names

  • Indian River Medical Center Doing business as

Other providers in Indian River, MI

All providers in Indian River, MI · Federally Qualified Health Center (FQHC) in Michigan

Sources for this page

Verify at the official NPI Registry.