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Baldwin Family Health Care

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

NPI 1962223453 · NPPES record last updated Aug 10, 2026

Key facts

NPI
1962223453
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
BALDWIN FAMILY HEALTH CARE
Practice address
351 N Main St
Kent City, MI 49330-9110
Phone
(616) 678-6002
NPI assigned
Oct 18, 2024
Organization subpart
Yes
Parent organization (as reported)
BALDWIN FAMILY HEALTH CARE

Authorized official

Name
Julie Tatko
Title
Ceo
Phone
(231) 745-5482

Other NPIs on the same Medicare enrollment 17

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

Other NPIs with the same Medicare PAC ID 18

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

Corporate family (same tax ID) 22

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

Practitioners 38

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

View all 38

Medicare participation

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

Federally qualified health center certification: CCN C71037

Legal name
BALDWIN FAMILY HEALTH CARE
Doing business as
KENT CITY HIGH SCHOOL BEHAVIORAL HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 30, 2024
Last certification
Oct 30, 2024
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
351 N Main St
Kent City, MI 49330-9110

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
Pamela Panetta
Individual 		Corporate Director
Board Chair		 Oct 1, 2018
Ashley Hawkins
Individual 		Corporate Director
Board Member		 Jan 23, 2023
Susan Olds
Individual 		Corporate Director
Secretary		 Jul 25, 2019
Mary Martin
Individual 		Corporate Director
Board Member		 Jul 25, 2022
Corey Vanfleet
Individual 		Corporate Director
Board Member		 May 1, 1996
Robert Fisher
Individual 		Corporate Director
Past Chair		 Apr 1, 1992
Eric Davidson
Individual 		Corporate Director
Vice Chair		 Sep 1, 1986
Seth Wenger
Individual 		Corporate Director
Treasurer		 Jul 1, 2024
Julie Tatko
Individual 		Corporate Officer
Ceo		 Sep 1, 2020
W-2 Managing Employee Sep 1, 2020
David Glancy
Individual 		Corporate Director
Board Member		 Jul 1, 2024
Mason Husby
Individual 		Corporate Officer
Cfo		 Aug 1, 2018

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040209001155 MI Part B Supplier - Clinic/Group Practice 1153215413 Receives reassigned benefits from 50 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grant, MI; Kent City, MI; Leroy, MI; McBain, MI; Newaygo, MI; Reed City, MI; White Cloud, MI; Cadillac, MI…
O20241106002266 MI Part a Provider - Federally Qualified Health Center (FQHC) 1153215413 Practice locations: Kent City, MI

National Provider Directory

Tax ID family
Rowland Family Health C (23 organizations share this tax ID)
Part of
Rowland Family Health C

Specialties & licenses

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

Addresses

Primary practice location

351 N Main St
Kent City, MI 49330-9110

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 876-6527

Other names

  • Kent City High School Behavioral Health Services Doing business as

Other providers in Kent City, MI

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

Sources for this page

Verify at the official NPI Registry.