Cherry Health - Southside Health Center Suite 200 – Federally Qualified Health Center (FQHC), NPI 1982279428

Cherry Health - Southside Health Center Suite 200 is a healthcare provider. based in Grand rapids, Michigan. specializing in Federally Qualified Health Center (FQHC). The NPI Number for Cherry Health - Southside Health Center Suite 200 is 1982279428

Main info

Organization
Name
Cherry Health - Southside Health Center Suite 200
NPI
1982279428
Phone
(616) 965-8209
Address
100 CHERRY ST SE
Authorized Official
TASHA BLACKMON CEO
Enumeration Date
26 May 2021
Last Update Date
31 August 2021
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 Cherry Health - Southside Health Center Suite 200

  • 100 CHERRY ST SE

    GRAND RAPIDS, MI 495034526

    Phone: (616) 965-8209

    Fax: (616) 940-5366

    Type: Mailing

  • 2303 KALAMAZOO AVE SE STE 200

    GRAND RAPIDS, MI 495073780

    Phone: (616) 965-8379

    Fax: (616) 940-5354

    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: 2021-12-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

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
O20211213000519OFederally Qualified Health Center (Fqhc)MITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

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 federal number belongs to Cherry Health - Southside Health Center Suite 200?
The federal identifier for Cherry Health - Southside Health Center Suite 200 is NPI 1982279428.
Is Cherry Health - Southside Health Center Suite 200's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does Cherry Health - Southside Health Center Suite 200 list a primary specialty?
If you are matching referrals, note Federally Qualified Health Center (FQHC) for Cherry Health - Southside Health Center Suite 200. Clinical services aligned with this taxonomy classification.
Where does public data place Cherry Health - Southside Health Center Suite 200?
The snapshot lists Grand Rapids, Michigan for Cherry Health - Southside Health Center Suite 200; download NPPES for the complete set.
Is Cherry Health - Southside Health Center Suite 200 a real provider?
This page reflects official NPPES data for NPI 1982279428. Always confirm identity and privileges with the practice and licensing boards.

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