NPIMap

Organization Active NPI

Baldwin Family Health Care

Doing business as Great Lakes Family Care

  • Federally Qualified Health Center (FQHC)
  • Cadillac, MI
National Provider Identifier
1982815932
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BALDWIN FAMILY HEALTH CARE
Doing business as
Great Lakes Family Care
Practice address
520 Cobb St
Cadillac, MI 49601-2588
Phone
(231) 775-6521
Fax
(231) 876-6519
NPI assigned
May 24, 2007
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
BALDWIN FAMILY HEALTH CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Ms. Julie Tatko
Title
Ceo
Phone
(231) 745-2743

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

520 Cobb St
Cadillac, MI 49601-2588

Mailing address

520 Cobb St
Cadillac, MI 49601-2588
Phone (231) 775-6521

Other identifiers 2

IdentifierTypeStateIssuer
700D360000OtherMIBCN
0D36000OtherBCBS

Other names 1

  • Great Lakes Family Care Doing business as

Medicare participation

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

Enrollment records 2

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…
O20070719000801 MI Part A Provider - Federally Qualified Health Center (FQHC) 1153215413 Practice locations: Cadillac, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982815932. Details of each certification follow.

Federally qualified health center certification: CCN 231921

Legal name
BALDWIN FAMILY HEALTH CARE
Doing business as
GREAT LAKES FAMILY CARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 31, 2007
Last certification
Aug 31, 2007
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 1, 1975 in MI
Enrollment address
520 Cobb St
Cadillac, MI 49601-2588

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Baldwin Family Hlthcare23 organizations share this tax ID, including this one
Part of
Baldwin Family Hlthcare

Other organizations with this tax ID 22

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

View all 22

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
Pamela Panetta Individual Corporate DirectorSecretary Oct 1, 2018
Ashley Hawkins Individual Corporate DirectorBoard Member Jan 23, 2023
Susan Olds Individual Corporate DirectorBoard Member Jul 25, 2019
Mary Martin Individual Corporate DirectorBoard Member Jul 25, 2022
Corey Vanfleet Individual Corporate DirectorBoard Member May 1, 1996
Robert Fisher Individual Corporate DirectorChairman of the Board Apr 1, 1995
Eric Davidson Individual Corporate DirectorVice Chair Sep 1, 1986
Julie Tatko Individual Corporate DirectorCeo Sep 1, 2020
W-2 Managing EmployeeCeo Sep 1, 2020
Mason Husby Individual Corporate OfficerVice President and Cfo Apr 1, 2018
Marissa Kelly Individual Corporate DirectorBoard Member Dec 1, 2021
Bruce Whitney Individual Corporate DirectorTreasurer Jan 23, 2014

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1982815932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-775-6521",
            "fax_number": "231-876-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012588",
            "telephone_number": "231-775-6521",
            "fax_number": "231-876-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALDWIN FAMILY HEALTH CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BALDWIN FAMILY HEALTH CARE",
        "enumeration_date": "2007-05-24",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "TATKO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "231-745-2743",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "700D360000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0D36000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.