NPIMap

Organization Active NPI

Family Health Center, Inc.

Doing business as Family Health Center - Burdick

  • Federally Qualified Health Center (FQHC)
  • Kalamazoo, MI
National Provider Identifier
1891005906
Registry record updated Mar 3, 2022
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.
Doing business as
Family Health Center - Burdick
Practice address
1308 N Burdick St
Kalamazoo, MI 49007-2553
Phone
(269) 488-0803
Fax
(269) 488-3410
NPI assigned
Oct 8, 2010
Last updated
Mar 3, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Authorized official

Name
Denise Crawford, MSW, MBA
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

1308 N Burdick St
Kalamazoo, MI 49007-2553

Mailing address

117 W Paterson St
Kalamazoo, MI 49007-2557

Other names 1

  • Family Health Center - Burdick Doing business as

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
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891005906. Details of each certification follow.

Federally qualified health center certification: CCN 231951

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

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
Tax ID family
Anil Patel MD6 organizations share this tax ID, including this one
Part of
Anil Patel MD

Other organizations with this tax ID 5

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

Locations

505 E Alcott St
Kalamazoo, MI 49001
Phone 2693492641 ext. 715

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1286496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1891005906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W PATERSON ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 N BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072553",
            "telephone_number": "269-488-0803",
            "fax_number": "269-488-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH CENTER, INC.",
        "enumeration_date": "2010-10-08",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "269-349-4257",
        "authorized_official_credential": "MSW, MBA"
    },
    "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": "Family Health Center - Burdick",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Health Center - Burdick",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.