NPIMap

Organization Active NPI

Fort Bend Family Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Richmond, TX
National Provider Identifier
1972601169
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FORT BEND FAMILY HEALTH CENTER, INC
Practice address
400 Austin St
Richmond, TX 77469-4406
Phone
(281) 342-4530
Fax
(281) 342-3832
NPI assigned
Sep 20, 2006
Last updated
Apr 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Authorized official

Name
Mr. Michael Dotson
Title
Chief Executive Officer
Phone
(281) 342-4530

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Multi-Specialty Clinic/Center 261QM1300X NU
Obstetrics & Gynecology Physician 207V00000X NU

Addresses

Primary practice location

400 Austin St
Richmond, TX 77469-4406

Mailing address

400 Austin St
Richmond, TX 77469-4406
Phone (281) 342-4530

Other identifiers 1

IdentifierTypeStateIssuer
092714701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040812000965 TX Part B Supplier - Clinic/Group Practice 7113999780 Receives reassigned benefits from 38 practitioners
Practice locations: Stafford, TX; Richmond, TX; Missouri City, TX; Brookshire, TX
O20100611000182 TX Part A Provider - Federally Qualified Health Center (FQHC) 7113999780 Practice locations: Richmond, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1972601169. Details of each certification follow.

Federally qualified health center certification: CCN 451876

Legal name
FORT BEND FAMILY HEALTH CENTER INC
Doing business as
ACCESS HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 16, 1993
Last certification
Sep 16, 1993
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Dec 8, 1975 in TX
Enrollment address
400 Austin St
Richmond, TX 77469-4406

Federally qualified health center certification: CCN 671852

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ACCESS HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 17, 2007
Last certification
Apr 17, 2007
Ownership / control type
For profit – partnership
Facility address
400 Austin Street
Richmond, TX 77469

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory

Locations

307 Texas Pkwy
Ste 100
Missouri City, TX 77489
Phone (281) 342-4530

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Alexandra Nicole Doty Individual Corporate DirectorSenior Director of Operations Apr 21, 2017
W-2 Managing Employee Nov 28, 2016
Jalisa Randle Individual W-2 Managing EmployeeProgram Manager Nov 17, 2014

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Accesshealth - BrookshireBrookshire, TX, CCN 741922 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1972601169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 AUSTIN ST",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774694406",
            "telephone_number": "281-342-4530",
            "fax_number": "281-342-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AUSTIN ST",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774694406",
            "telephone_number": "281-342-4530",
            "fax_number": "281-342-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT BEND FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "DOTSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "281-342-4530",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092714701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.