NPIMap

Organization Active NPI

Ohio Hills Health Services

Doing business as Freeport Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Freeport, OH
National Provider Identifier
1275579484
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
OHIO HILLS HEALTH SERVICES
Doing business as
Freeport Family Health Center
Ohio Hills Health Center Freeport
Practice address
110 West Main St
Freeport, OH 43973
Phone
(740) 658-3329
NPI assigned
Jun 22, 2006
Last updated
Nov 3, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
OHIO HILLS HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Authorized official

Name
Mr. Jeffrey Britton
Title
Executive Director
Phone
(740) 239-6447

Specialties & licenses 1

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

Addresses

Primary practice location

110 West Main St
Freeport, OH 43973

Mailing address

110 West Main St
Freeport, OH 43973
Phone (740) 658-3329

Other names 2

  • Freeport Family Health Center Doing business as
  • Ohio Hills Health Center Freeport Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080207000294 OH Part A Provider - Federally Qualified Health Center (FQHC) 7113990177 Practice locations: Freeport, OH
O20140807002203 OH Part B Supplier - Clinic/Group Practice 7113990177 Receives reassigned benefits from 21 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Clairsville, OH; Woodsfield, OH; Quaker City, OH; Freeport, OH; Bellaire, OH; Barnesville, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275579484. Details of each certification follow.

Federally qualified health center certification: CCN 361828

Legal name
OHIO HILLS HEALTH SERVICES
Doing business as
FREEPORT FAMILY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jan 22, 1973 in OH
Enrollment address
110 W Main St
Freeport, OH 43973-9801

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Part of
Monroe Family Health Ce

Locations

349 35th St
Bellaire, OH 43906
Phone (740) 239-6447

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Brad Hudson Individual Corporate OfficerPresident Feb 1, 2014
Robert Koch Individual Corporate DirectorBoard Member Jul 23, 2018
Tim McKelvey Individual Corporate DirectorBoard Member Jun 19, 2017
Teresa Lyle Individual W-2 Managing Employee Oct 1, 1998
Dee Stewart Individual W-2 Managing EmployeeDirector of Revenue Cycle MGT. Dec 14, 2015
Nancy Tipton Individual Corporate Director Aug 17, 2007
Charles Bardall Individual Corporate Director May 1, 1976
Amber N Bauer Individual Corporate Director Jul 1, 2009
W-2 Managing Employee Jul 1, 2009
Brent Tisher Individual Corporate Director Feb 1, 2010
Sylvia Bowen Individual Corporate Director Aug 17, 2007
Russell S Lee-Wood Individual Corporate Director Aug 1, 1996
W-2 Managing Employee Aug 1, 1996
Michael Carpenter Individual Corporate OfficerCoo Nov 16, 2017
W-2 Managing EmployeeCoo Nov 16, 2017
Leslie Tickhill Individual Corporate DirectorBoard Member Apr 1, 2018
Carol Davolio Individual W-2 Managing EmployeeClinical Director Mar 9, 2016
Donna Secrest Individual Corporate Director Feb 1, 2014
Karen Gilham Individual W-2 Managing EmployeeHuman Resources Coordinator Jul 1, 1982
Jeff Britton Individual Corporate OfficerCeo Dec 15, 2014

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1275579484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 WEST MAIN ST",
            "city": "FREEPORT",
            "state": "OH",
            "postal_code": "43973",
            "telephone_number": "740-658-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WEST MAIN ST",
            "city": "FREEPORT",
            "state": "OH",
            "postal_code": "43973",
            "telephone_number": "740-658-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO HILLS HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OHIO HILLS HEALTH SERVICES",
        "enumeration_date": "2006-06-22",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "BRITTON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "740-239-6447",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freeport Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ohio Hills Health Center Freeport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, OH

Sources for this page

Verify at the official NPI Registry.