NPIMap

Organization Active NPI

Grace Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Battle Creek, MI
National Provider Identifier
1942058458
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GRACE HEALTH, INC.
Practice address
175 College St Ste 100
Battle Creek, MI 49037-3432
Phone
(269) 966-2600
NPI assigned
May 9, 2024
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Peter S ChangNPI 1205814811
Title
President / Ceo
Phone
(269) 965-8866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

175 College St Ste 100
Battle Creek, MI 49037-3432

Mailing address

181 Emmett St W
Battle Creek, MI 49037-2963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040206000435 MI Part B Supplier - Clinic/Group Practice 1052229226 Receives reassigned benefits from 52 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Battle Creek, MI
O20241210003990 MI Part A Provider - Federally Qualified Health Center (FQHC) 1052229226 Practice locations: Battle Creek, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942058458. Details of each certification follow.

Federally qualified health center certification: CCN C71039

Legal name
GRACE HEALTH INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 25, 2024
Last certification
Nov 25, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 8, 1986 in MI
Enrollment address
175 College St
Ste 100
Battle Creek, MI 49037-3432

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center of21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

16 Emmett St E
Ste 2
Battle Creek, MI 49017
Phone (269) 965-8866

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
Shannon Bagley Individual Corporate DirectorBoard Member Sep 13, 2023
Dean P Newsome Individual Corporate DirectorBoard Member Jul 9, 2014
Timothy Kool Individual Corporate DirectorBoard Member Jul 10, 2019
Yanira Flores Individual Corporate DirectorBoard Member Mar 11, 2020
Ann K. Gallagher Individual Corporate DirectorBoard Member Oct 21, 2010
Katherine Segal Individual Corporate DirectorBoard Member Oct 10, 2018
Latosha R Potter Individual Corporate DirectorBoard Member Jul 13, 2011
James E. Reed Individual Corporate DirectorBoard Member Oct 21, 2010
Tha Par Individual Corporate DirectorBoard Member Feb 12, 2020
Peter S Chang Individual Corporate Director Jul 1, 2017
W-2 Managing EmployeePresident / Ceo Jul 1, 2017
Bridgette R Jones Individual Corporate DirectorBoard Member Sep 13, 2017

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 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1715212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1942058458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 EMMETT ST W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 COLLEGE ST STE 100",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490373432",
            "telephone_number": "269-966-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-09",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "269-965-8866"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.