Family Health Center, Inc.

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

NPI 1891005906 · NPPES record last updated Mar 3, 2022

Key facts

NPI
1891005906
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
FAMILY HEALTH CENTER, INC.
Practice address
1308 N Burdick St
Kalamazoo, MI 49007-2553
Phone
(269) 488-0803
Fax
(269) 488-3410
NPI assigned
Oct 8, 2010
Organization subpart
Yes
Parent organization (as reported)
FAMILY HEALTH CENTER, INC.

Authorized official

Name
Denise Crawford, MSW, MBA
Title
President and Ceo
Phone
(269) 349-4257

Other NPIs on the same Medicare enrollment 9

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

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 5

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

Practitioners 59

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

View all 59

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Federally qualified health center certification: CCN 231951

Legal name
FAMILY HEALTH CENTER, INC.
Doing business as
FAMILY HEALTH CENTER, BURDICK
Organization structure
Other · Non-profit
Incorporated
Jan 1, 1971 in MI
Enrollment address
1308 N Burdick St
Kalamazoo, MI 49007-2553

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
Denise R Crawford
Individual
Corporate Director
Ceo
Feb 23, 2009
W-2 Managing Employee Nov 1, 2010
Kharen Warfield Shelton
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Teresa Thrash
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Patrick Allen Troman
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Loretta Cain
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Robin Hall
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Katie Harrelson
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Eileen Chiang
Individual
Corporate Director
Cfo
Feb 1, 2010
W-2 Managing Employee Nov 1, 2010
Paul Spaude
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013
Ollie Chambers
Individual
Corporate Director
Board Member
Jan 11, 2013
Other
Board Member
Jan 11, 2013

Medicare enrollment records

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
This NPI is an additional NPI on the enrollment
Practice locations: Kalamazoo, MI
O20110104000235 MI Part a Provider - Federally Qualified Health Center (FQHC) 1759370216 Practice locations: Kalamazoo, MI

National Provider Directory

Tax ID family
Anil Patel MD (6 organizations share this tax ID)
Part of
Anil Patel MD

Locations

117 W Paterson St
Kalamazoo, MI 49007

Specialties & licenses

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

Addresses

Primary practice location

1308 N Burdick St
Kalamazoo, MI 49007-2553

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557

Other names

  • Family Health Center - Burdick Doing business as

Other providers in Kalamazoo, MI

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

Sources for this page

Verify at the official NPI Registry.