NPIMap

Organization Active NPI

Hamilton Center Inc.

Doing business as Grace Clinic Health Professional

  • Federally Qualified Health Center (FQHC)
  • Terre Haute, IN
National Provider Identifier
1205446259
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HAMILTON CENTER INC.
Doing business as
Grace Clinic Health Professional
Practice address
622 8TH Avenue
Terre Haute, IN 47804-4780
Phone
(812) 231-8200
NPI assigned
Aug 5, 2020
Last updated
Aug 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Melvin L Burks
Title
President/Ceo
Phone
(812) 231-8296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

622 8TH Avenue
Terre Haute, IN 47804-4780

Mailing address

620 8TH Ave
Terre Haute, IN 47804-2771
Phone (812) 231-8200

Other names 1

  • Grace Clinic Health Professional Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201001001910 IN Part A Provider - Federally Qualified Health Center (FQHC) 4284533662 Practice locations: Terre Haute, IN
O20201201002241 IN Part A Provider - Federally Qualified Health Center (FQHC) 4284533662 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Greencastle, IN

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1205446259. Details of each certification follow.

Federally qualified health center certification: CCN 151083

Legal name
HAMILTON CENTER, INC.
Doing business as
GRACE CLINIC HEALTH PROFESSIONAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 2020
Last certification
Oct 1, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
622 8TH Ave
Terre Haute, IN 47804-2744

Federally qualified health center certification: CCN 151172

Legal name
HAMILTON CENTER, INC.
Doing business as
GRACE CLINIC HEALTH PROFESSIONAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 2020
Last certification
Dec 1, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 27, 1967 in IN
Enrollment address
239 Hillsdale Ave
Ste a
Greencastle, IN 46135-1340

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

622 8th Ave
Terre Haute, IN 47804
Phone (812) 231-8171

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Paul Lockhart Individual Corporate OfficerPresident of Board of Director Oct 1, 2024
Norman Lowery Individual Corporate OfficerSecretary of Board of Directors Oct 1, 2024
Meghan Creech Individual W-2 Managing EmployeeChief of Quality Jan 1, 2023
Melvin Burks Individual Corporate Director Jan 1, 2012
W-2 Managing EmployeeCeo Jan 1, 2012 100%
Operational/Managerial ControlCeo Jan 1, 2012
5% Or Greater Direct Ownership Interest Jan 1, 2012
W-2 Managing EmployeeCeo Jan 1, 2012
Mark Baker Individual Corporate OfficerTreasurer of the Board of Directors Oct 1, 2024
Tracie Session Individual W-2 Managing EmployeeCfo Jan 1, 2021
Hamilton Center, Inc. Organization, Terre Haute, IN Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2012 100%
Operational/Managerial Control Jan 1, 2012
Selena Cannady Individual W-2 Managing EmployeeLead Provider Relations Specialist Jan 1, 2012
W-2 Managing Employee Jan 1, 2012
Daphne Session Individual W-2 Managing EmployeeChief of Grace Clinic Professional May 16, 2022
Amy Hardy Individual Corporate OfficerVice President of Board of Director Oct 1, 2024
Dana Guthrie Individual W-2 Managing Employee Jan 1, 2012
Rick Stevens Individual Corporate OfficerBod President Jan 1, 2019
Robb a. Johnson Individual W-2 Managing EmployeeChief Operating Officer Jan 1, 2012
Yvonne Utley Individual W-2 Managing EmployeeCfo Jan 1, 2012
Tanya Michelle Baker Individual W-2 Managing EmployeeExec Dir Compliance Jan 1, 2012
Haley Ringwald Individual Corporate OfficerBod Secretary Jan 1, 2019

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Hamilton Center Inc.

    dba Grace Clinic Health Professional

    • Federally Qualified Health Center (FQHC)
    • Greencastle, IN
    • NPI 1699558577

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Hamilton Center, Inc.
    • Community/Behavioral Health Agency
    • Terre Haute, IN
    • NPI 1205980901

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Hamilton Center, Inc.
    • Psychiatric Hospital
    • Terre Haute, IN
    • NPI 1578617627

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Hamilton Center, Inc.

    dba Western Indiana Recovery Services

    • Methadone Clinic
    • Terre Haute, IN
    • NPI 1790286300

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hamilton Center, Inc.Terre Haute, IN, CCN 154009 Hospital Operational/Managerial Control (100%) Aug 25, 1967

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1596585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1205446259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042771",
            "telephone_number": "812-231-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 8TH AVENUE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478044780",
            "telephone_number": "812-231-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-05",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "BURKS",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "812-231-8296"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Clinic Health Professional",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grace Clinic Health Professional",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.