Butler County Community Health Consortium, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Middletown, OH
NPI 1124504378 · NPPES record last updated Nov 3, 2023
Key facts
- NPI
- 1124504378
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
- Practice address
- 601 N Breiel Blvd Ste B
Middletown, OH 45042 - Phone
- (513) 454-1111
- NPI assigned
- Jul 11, 2018
- Organization subpart
- No
Authorized official
- Name
- Ryan G. Randall
- Title
- Cfo
- Phone
- (513) 454-1468
Owners & managing parties with NPI records 1
-
Stephen Joseph Roller, C.N.P.
Other NPIs on the same Medicare enrollment 18
Other NPIs with the same Medicare PAC ID 18
Practitioners 62
-
Megan Payne, APRN
-
Kelsey Wolfe, APRN
-
Megan Nichole Ward, CNP
-
Lovepreet Kaur Ahluwalia, FNP-C
-
Crystal Allen, MSW, LISW
-
Stephanie Babb, LSW
-
Kara Marie Beckman, APRN, PMHNP-BC
-
Krystal Bellamy, MSN, APRN, CNP
-
Robert E Brown Jr., LPCC-S
-
Alex Bunce, D.O.
-
Lindsay C Burns, LPC
-
Kara Carroll, PA-C
-
Julie A Cianchetti-Bridgeford, C.N.P.
-
Alicia M Collins, FNP-C
-
Michelle R Cooley, APRN
-
Caitlyn Davidson, LISW
-
Micah R Davis, D.O.
-
Jake Elmlinger, CNP
-
Brooke Fey, MSW, LISW
-
John Wesley Greene, CNP
-
John T Harlan, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OH
Federally qualified health center certification: CCN 361184
- Legal name
- BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM INC
- Doing business as
- PRIMARY HEALTH SOLUTIONS
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Sep 27, 2018
- Last certification
- Sep 27, 2018
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 15, 2018 in OH
- Enrollment address
- 601 N Breiel Blvd
Ste B
Middletown, OH 45042-3801
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Josue Colon |
Corporate Director |
Jan 1, 2024 | |
| Chad Creech |
Corporate Director |
Jan 1, 2024 | |
| Monica Scalf |
Corporate Director |
Mar 1, 2026 | |
| Gustavo Cocina |
Corporate Director |
Mar 1, 2026 | |
| William Andrew Groth |
Corporate Director |
Mar 1, 2026 | |
| Samuel Broyles |
Corporate Director |
Mar 1, 2026 | |
| Arvind Joshi |
Corporate Director |
Jan 1, 2024 | |
| Cynamon Trokhan |
Corporate Director |
Mar 1, 2026 | |
| Sandra Rutledge |
Corporate Director |
Mar 1, 2026 | |
| Ashley Banks |
W-2 Managing Employee | Jan 1, 2024 | |
| Elizabeth Mohr |
Corporate Officer |
Apr 20, 2026 | |
| Dennis Kidd |
Corporate Director |
Jan 1, 2024 | |
| Stephen J Roller |
Operational/Managerial Control |
Jan 1, 2024 | |
| Michelle Miller |
Corporate Director |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040304000056 | OH | Part B Supplier - Clinic/Group Practice | 7810884780 |
Receives reassigned benefits from 58 practitioners 18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fairfield Township, OH; Trenton, OH; Oxford, OH; Middletown, OH; Hamilton, OH; Dayton, OH; Fairfield, OH |
| O20181005000784 | OH | Part a Provider - Federally Qualified Health Center (FQHC) | 7810884780 | Practice locations: Middletown, OH |
National Provider Directory
Locations
601 N Breiel Blvd
Unit B
Middletown, OH 45042
Phone 5134541111 ext. 41111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
601 N Breiel Blvd Ste B
Middletown, OH 45042
Mailing address
PO Box 837
Hamilton, OH 45012-0837
Phone (515) 454-1468
Other providers in Middletown, OH
- Destini Burns
- Jessica Buschur
- India C Bush
- Marcenta Clay Bush
- Butler County Community Health Consortium Inc
- Butler County Community Health Consortium, Inc.
- Butler County Community Health Consortium, Inc.
- Butler County Community Health Consortium, Inc.
- Butler County Community Health Consortium, Inc.
- Daniel A Butler
All providers in Middletown, OH · Federally Qualified Health Center (FQHC) in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.