NPIMap

Organization Active NPI

Western Wayne Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Inkster, MI
National Provider Identifier
1972530277
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WESTERN WAYNE FAMILY HEALTH CENTERS
Practice address
2700 Hamlin Blvd
Inkster, MI 48141-2206
Phone
(313) 561-5100
Fax
(313) 565-0309
NPI assigned
Jun 26, 2006
Last updated
Oct 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Ms. Linda Atkins
Title
Ceo
Phone
(313) 561-5100

Specialties & licenses 1

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

Addresses

Primary practice location

2700 Hamlin Blvd
Inkster, MI 48141-2206

Mailing address

2700 Hamlin Blvd
Inkster, MI 48141-2206
Phone (313) 561-5100

Other identifiers 2

IdentifierTypeStateIssuer
1972530277MedicaidMI
700H228520OtherMIBCBS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060815000295 MI Part A Provider - Federally Qualified Health Center (FQHC) 4082617998 Practice locations: Inkster, MI
O20060926000287 MI Part B Supplier - Clinic/Group Practice 4082617998 Receives reassigned benefits from 43 practitioners
4 other NPIs on this enrollment
Practice locations: Dearborn, MI; Ecorse, MI; Inkster, MI; Lincoln Park, MI; Taylor, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972530277. Details of each certification follow.

Federally qualified health center certification: CCN 231918

Legal name
WESTERN WAYNE FAMILY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 18, 2006
Last certification
Oct 18, 2006
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 2004 in MI
Enrollment address
2700 Hamlin Blvd
Inkster, MI 48141-2206

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 4

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

National Provider Directory

National Provider Directory

Locations

26650 Eureka Rd
#C1
Taylor, MI 48180
Phone (734) 941-4991

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Saif Alsenad Individual Corporate Director Oct 1, 2023
Melissa Stellini Individual Corporate DirectorSecretary Dec 1, 2018
Walter Starghill Individual Corporate DirectorChairman Jan 1, 2015
Linda Atkins Individual Corporate OfficerCeo Nov 12, 2008
W-2 Managing EmployeeCeo Nov 12, 2008
Arnold Gregory Individual Corporate Director Aug 1, 2022
Steven D Smith Individual Corporate Director Nov 3, 2021
Rachel M Cushman Individual Corporate Director Aug 1, 2022
Christina Arnold Individual Corporate Director Aug 1, 2013
William Miller Individual Corporate DirectorTreasurer Sep 1, 2014
Velma Jean Overman Individual Corporate DirectorVice Chairperson Mar 28, 2013
Carlotta Mitchell Individual Corporate Director Nov 21, 2023
Anita Goree Individual Corporate DirectorTreasurer Feb 1, 2018

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1972530277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 HAMLIN BLVD",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481412206",
            "telephone_number": "313-561-5100",
            "fax_number": "313-565-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HAMLIN BLVD",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481412206",
            "telephone_number": "313-561-5100",
            "fax_number": "313-565-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WAYNE FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "ATKINS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-561-5100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972530277",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700H228520",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inkster, MI

Sources for this page

Verify at the official NPI Registry.