NPIMap

Organization Active NPI

Northwest Michigan Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Benzonia, MI
National Provider Identifier
1922464254
Registry record updated Mar 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHWEST MICHIGAN HEALTH SERVICES, INC.
Practice address
6051 Frankfort Hwy
Benzonia, MI 49616-9558
Phone
(231) 947-1112
Fax
(231) 947-7739
NPI assigned
Dec 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2024

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

Authorized official

Name
Ms. Heidi Mae Britton, MPH,
Title
Cheif Executive Officer
Phone
(231) 947-1112

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X MI Primary

Addresses

Primary practice location

6051 Frankfort Hwy
Benzonia, MI 49616-9558

Mailing address

10767 E Traverse Hwy
Traverse City, MI 49684-6219
Phone (231) 947-0351

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160121001826 MI Part A Provider - Federally Qualified Health Center (FQHC) 6608007729 Practice locations: Benzonia, MI

Federally qualified health center certification: CCN 231084

Legal name
NORTHWEST MICHIGAN HEALTH SERVICES INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 21, 2016
Last certification
Jan 21, 2016
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
6051 Frankfort Hwy
Benzonia, MI 49616-9558

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Northwest Michigan Health Services Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Dalia Estrada Individual Corporate DirectorBoard Member Oct 1, 2022
Karen M Goodman Individual Corporate Director Apr 1, 2021
Rochelle a Radlinski Individual Corporate DirectorSecretary Apr 1, 2021
Jose Edson Pontes Individual Corporate Director Feb 24, 2019
Mindy M Aguilar Individual W-2 Managing EmployeeDirector of Human Resources Jun 10, 2013
Fernando Meza Individual Corporate Director Oct 1, 2016
Larry K Vansickle Individual Corporate OfficerTreasurer Jun 5, 2005
Lauren Flynn Individual Corporate DirectorBoard Member Nov 1, 2023
Meghan J Davis Individual Corporate Director Sep 1, 2023
Callie Barr Individual Corporate DirectorBoard Member Nov 1, 2023
Lisa Allen Individual Corporate DirectorVice President Oct 1, 2022
Kirk E Myers Individual Corporate OfficerPresident of Board Mar 11, 2008
Heidi M Britton Individual Corporate OfficerChief Executive Officer Jul 28, 2014
Operational/Managerial ControlChief Executive Officer Jul 28, 2014
David a Wild Individual Corporate DirectorBoard Member Aug 1, 2012

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1451520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1922464254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10767 E TRAVERSE HWY",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846219",
            "telephone_number": "231-947-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 FRANKFORT HWY",
            "city": "BENZONIA",
            "state": "MI",
            "postal_code": "496169558",
            "telephone_number": "231-947-1112",
            "fax_number": "231-947-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MICHIGAN HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-31",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "BRITTON",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "231-947-1112",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPH,"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benzonia, MI

Sources for this page

Verify at the official NPI Registry.