NPIMap

Organization Active NPI

Butler County Community Health Consortium, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oxford, OH
National Provider Identifier
1225400765
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
Practice address
10 N Locust St
Suite a
Oxford, OH 45056-1192
Phone
(513) 454-1460
NPI assigned
Oct 23, 2015
Last updated
Nov 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Ryan Randall
Title
Cfo
Phone
(513) 454-1468

Specialties & licenses 1

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

Addresses

Primary practice location

10 N Locust St
Suite a
Oxford, OH 45056-1192

Mailing address

PO Box 837
Hamilton, OH 45012-0837
Phone (513) 454-1460

Other names 1

  • Oxford Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
O20160217001352 OH Part A Provider - Federally Qualified Health Center (FQHC) 7810884780 Practice locations: Oxford, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225400765. Details of each certification follow.

Federally qualified health center certification: CCN 361099

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
Feb 17, 2016
Last certification
Feb 17, 2016
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jan 28, 2000 in OH
Enrollment address
10 N Locust St
Ste a
Oxford, OH 45056-1182

Other NPIs with the same Medicare PAC ID 18

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

View all 18

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory

Locations

211 Donald Dr
Ste B
Fairfield, OH 45014

300 High St
Fl 4
Hamilton, OH 45011
Phone (513) 454-1460

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Josue Colon Individual Corporate DirectorTrustee Mar 1, 2026
Chad Creech Individual Corporate DirectorPresident Jan 1, 2023
Monica Scalf Individual Corporate DirectorTrustee Mar 1, 2026
Gustavo Cocina Individual Corporate DirectorTrustee Mar 1, 2026
William Andrew Groth Individual Corporate DirectorSecretary Jan 1, 2023
Samuel Broyles Individual Corporate DirectorTrustee Mar 1, 2026
Arvind Joshi Individual Corporate DirectorTreasurer Jan 1, 2023
Cynamon Trokhan Individual Corporate DirectorVice President Jan 1, 2023
Sandra Rutledge Individual Corporate DirectorTrustee Mar 1, 2026
Ashley Banks Individual W-2 Managing EmployeeCredentialing Specialist Nov 25, 2019
Elizabeth Mohr Individual Corporate OfficerCfo Apr 20, 2026
Dennis Kidd Individual Corporate DirectorTrustee Mar 1, 2026
Stephen J Roller Individual Operational/Managerial ControlCeo Jan 1, 2023
Michelle Miller Individual Corporate DirectorTrustee Mar 1, 2026

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1225400765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 837",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450120837",
            "telephone_number": "513-454-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N LOCUST ST",
            "address_2": "SUITE A",
            "city": "OXFORD",
            "state": "OH",
            "postal_code": "450561192",
            "telephone_number": "513-454-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "513-454-1468"
    },
    "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": "Oxford Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Oxford Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oxford, OH

Sources for this page

Verify at the official NPI Registry.