CHERRY HEALTH - SOUTHSIDE HEALTH CENTER SUITE 200
NPI 1982279428
Clinic/Center - Federally Qualified Health Center (FQHC) in Grand Rapids, MI

Q: What is Cherry Street Services Inc's NPI number?

The NPI number for Cherry Street Services Inc is 1982279428. It was assigned to this organization in the NPPES registry on May 26, 2021. The provider is doing business as Cherry Health - Southside Health Center Suite 200.

Q: What is Cherry Street Services Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since May 26, 2021

2303 KALAMAZOO AVE SE STE 200, GRAND RAPIDS, MI 49507(616) 965-8379(616) 940-5354 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Cherry Health - Southside Health Center Suite 200 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHERRY HEALTH - SOUTHSIDE HEALTH CENTER SUITE 200 (NPI 1982279428) is a healthcare organization registered as a federally qualified health center (fqhc) in Grand Rapids, Michigan and active in the NPI registry since May 2021. The organization lists Tasha Blackmon, Ceo, as its authorized official.

NPPES Registry Identity

NPI1982279428

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameCHERRY STREET SERVICES INC

Location Address2303 KALAMAZOO AVE SE STE 200Grand Rapids, MI 49507-3780

Mailing Address100 Cherry St SeGrand Rapids, MI 49503-4526 · (616) 965-8209 · Fax (616) 940-5366

Phone(616) 965-8379

Fax(616) 940-5354

Organization SubpartYes

Authorized OfficialTasha BlackmonCeo · (616) 965-8200

Enumeration DateMay 26, 2021

Last NPPES UpdateAugust 31, 2021

NPPES CertifiedAugust 31, 2021

✔ NPI 1982279428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 9

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedPsychologist · Addiction (Substance Use Disorder)Taxonomy 103TA0400X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedAnesthesiologyTaxonomy 207L00000X

Also ListedAnesthesiology · Addiction MedicineTaxonomy 207LA0401X

Also ListedEmergency MedicineTaxonomy 207P00000X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

2303 KALAMAZOO AVE SE STE 200, Grand Rapids, MI 49507

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Other Names 1

Doing Business AsCherry Health - Southside Health Center Suite 200

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cherry Health - Southside Health Center Suite 200 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateMichiganEnrollment IDO20211213000519Part A · Federally Qualified Health Center (FQHC)Due dateDecember 31, 2026

Source: CMS Revalidation Due Date List, October 2026 release.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cherry Street Services Inc's NPI number?

The NPI number for Cherry Street Services Inc is 1982279428. It was assigned to this organization in the NPPES registry on May 26, 2021. The provider is doing business as Cherry Health - Southside Health Center Suite 200.

Where is Cherry Street Services Inc located?

Cherry Street Services Inc is located at 2303 Kalamazoo Ave SE Ste 200, Grand Rapids, MI 49507. The listed phone number is (616) 965-8379.

What is Cherry Street Services Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Is Cherry Street Services Inc enrolled in Medicare?

Yes. Cherry Street Services Inc is registered in the Medicare PECOS enrollment system.

When is Cherry Street Services Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Michigan, Federally Qualified Health Center (FQHC)) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Cherry Street Services Inc accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Cherry Street Services Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Cherry Street Services Inc was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.