NPIMap

Organization Active NPI

Hillsdale Community Health Center

  • Rural Health Clinic/Center
  • Reading, MI
National Provider Identifier
1053472522
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
233965 Issued in MI
Legal business name
HILLSDALE COMMUNITY HEALTH CENTER
Practice address
143 S Main St
Reading, MI 49274
Phone
(517) 283-1772
NPI assigned
Dec 12, 2006
Last updated
Jul 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Authorized official

Name
Mark Gross
Title
Chief Financial Officer
Phone
(517) 437-5232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 233965 MI Primary

Addresses

Primary practice location

143 S Main St
Reading, MI 49274

Mailing address

143 S Main St
Reading, MI 49274-9101
Phone (517) 283-1772

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040805000518 MI Part B Supplier - Clinic/Group Practice 7214846260 Receives reassigned benefits from 121 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hillsdale, MI; Reading, MI
O20170201001046 MI Part A Provider - Rural Health Clinic 7214846260 Practice locations: Reading, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053472522. Details of each certification follow.

Rural health clinic certification: CCN 238699

Legal name
HILLSDALE COMMUNITY HEALTH CENTER
Doing business as
READING HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 1, 2016
Last certification
Aug 27, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 3, 1995 in MI
Enrollment address
143 S Main St
Reading, MI 49274-9101
Related CCNs
230037

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0987819Reading Health Clinic143 S Main Street, Reading, MI 49274Certificate of waiverJul 1, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Mark a Gross Individual Corporate OfficerCfo Apr 2, 2018
Seth Gibson Individual Operational/Managerial ControlDirector of Outpatient Clinics Sep 1, 2019 100%
Jeremiah Hodshire Individual Corporate OfficerCeo/President May 29, 2020 100%
US Bank National Association Organization, Cleveland, OH Financial institution 5% Or Greater Mortgage Interest Aug 1, 2016 57%

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hillsdale Health & WellnessHillsdale, MI, CCN 238725 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 18, 2019

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 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1053472522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 S MAIN ST",
            "city": "READING",
            "state": "MI",
            "postal_code": "492749101",
            "telephone_number": "517-283-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S MAIN ST",
            "city": "READING",
            "state": "MI",
            "postal_code": "49274",
            "telephone_number": "517-283-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSDALE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "517-437-5232"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "MI",
            "license": "233965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, MI

Sources for this page

Verify at the official NPI Registry.