Godwin Heights Middle School – Federally Qualified Health Center (FQHC), NPI 1104423508

Godwin Heights Middle School is a healthcare provider. based in Grand rapids, Michigan. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Godwin Heights Middle School is 1104423508

Main info

Organization
Name
Godwin Heights Middle School
NPI
1104423508
Phone
(616) 965-8200
Address
100 CHERRY ST SE
Authorized Official
TASHA BLACKMON CEO
Enumeration Date
8 October 2020
Last Update Date
25 August 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness80
Years active:5State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Godwin Heights Middle School

  • 100 CHERRY ST SE

    GRAND RAPIDS, MI 495034526

    Phone: (616) 965-8200

    Type: Mailing

  • 100 WEXFORD ST SE RM 214

    WYOMING, MI 495482212

    Phone: (616) 252-2070

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-10-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2026-02-28 (104 days ago).

Enrollment records

1

Earliest due date

2026-02-28

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20201019002077OFederally Qualified Health Center (Fqhc)MI2026-02-28

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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Reviews

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Frequently asked questions

What is the registry number for Godwin Heights Middle School?
The registry entry for Godwin Heights Middle School shows NPI 1104423508.
Is Godwin Heights Middle School currently accepting referrals based on NPI status?
Registry metadata lists Godwin Heights Middle School as active.
Which specialty label fits Godwin Heights Middle School?
NPPES ties Godwin Heights Middle School to Federally Qualified Health Center (FQHC) in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Godwin Heights Middle School?
Godwin Heights Middle School is associated with Grand Rapids, Michigan in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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