NPIMap

Organization Active NPI

Alcona Citizens for Health, Inc.

Doing business as Community Health Center of Northern Michigan

  • Federally Qualified Health Center (FQHC)
  • Harbor Springs, MI
National Provider Identifier
1891926739
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALCONA CITIZENS FOR HEALTH, INC.
Doing business as
Community Health Center of Northern Michigan
Practice address
3434 M 119
Ste C
Harbor Springs, MI 49740-9373
Phone
(231) 348-9900
Fax
(989) 358-3780
NPI assigned
Jul 27, 2009
Last updated
Mar 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Authorized official

Name
Ms. Christine Baumgardner
Title
Executive Director
Phone
(989) 736-3020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Physician Assistant 363A00000X
Counselor 101Y00000X
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

3434 M 119
Ste C
Harbor Springs, MI 49740-9373

Mailing address

3434 M 119
Suite C
Harbor Springs, MI 49740-9373
Phone (231) 348-9900

Other names 1

  • Community Health Center of Northern Michigan Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091102000611 MI Part A Provider - Federally Qualified Health Center (FQHC) 5991691958 Practice locations: Harbor Springs, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891926739. Details of each certification follow.

Federally qualified health center certification: CCN 231946

Legal name
ALCONA CITIZENS FOR HEALTH INC
Doing business as
COMMUNITY HEALTH CENTER OF NORTHERN MICHIGAN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 11, 2009
Last certification
Dec 11, 2009
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1978 in MI
Enrollment address
3434 M 119
Ste C
Harbor Springs, MI 49740-9373

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1102012Community Health Center of Northern Michigan3434 M-119, Suite C, Harbor Springs, MI 49740Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Alcona Health Center43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Locations

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

Ownership & related parties

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
Angela Bruning Individual Corporate OfficerBoard Member May 1, 2024
Teri Johnson Individual Corporate OfficerBoard Member May 20, 2021
Shelley Chamberlain Individual Corporate Officer Apr 14, 2016
Joseph P Garber Individual Corporate OfficerBoard Member Dec 9, 2004
Scott Korb Individual Corporate OfficerBoard Member Jan 20, 2022
Nancy Spencer Individual Corporate DirectorCeo Jan 1, 2018 100%
W-2 Managing Employee Jan 1, 2018 100%
Carolyn N Brummund Individual Corporate OfficerBoard Member Aug 10, 2000
Michael Erickson Individual Corporate OfficerBoard Member Apr 1, 2023
Gail Stimson Individual Corporate OfficerBoard Member Feb 1, 2023
Richard B Sangster Individual Corporate OfficerBoard Member Feb 16, 2017
Amy Matuzak Individual Corporate OfficerBoard Member Feb 1, 2026

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1891926739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 M 119",
            "address_2": "SUITE C",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409373",
            "telephone_number": "231-348-9900",
            "fax_number": "989-358-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 M 119",
            "address_2": "STE C",
            "city": "HARBOR SPRINGS",
            "state": "MI",
            "postal_code": "497409373",
            "telephone_number": "231-348-9900",
            "fax_number": "989-358-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALCONA CITIZENS FOR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-27",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "BAUMGARDNER",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "989-736-3020",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Northern Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harbor Springs, MI

Sources for this page

Verify at the official NPI Registry.