NPIMap

Organization Active NPI

Highland Health Providers Corp

  • Federally Qualified Health Center (FQHC)
  • Hillsboro, OH
National Provider Identifier
1366906844
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HIGHLAND HEALTH PROVIDERS CORP
Practice address
11130 North Shore Drive
Hillsboro, OH 45133
Phone
(937) 402-5491
NPI assigned
Jan 29, 2019
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Meghann Ackley
Title
Cfo
Phone
(937) 840-6617

Specialties & licenses 1

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

Addresses

Primary practice location

11130 North Shore Drive
Hillsboro, OH 45133

Mailing address

11130 North Shore Drive
Hillsboro, OH 45133
Phone (937) 402-5491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190423001735 OH Part A Provider - Federally Qualified Health Center (FQHC) 0244257848 Practice locations: Hillsboro, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366906844. Details of each certification follow.

Federally qualified health center certification: CCN 721806

Legal name
HIGHLAND HEALTH PROVIDERS CORP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 2, 2019
Last certification
Apr 2, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 6, 2001 in OH
Enrollment address
11130 N Shore Dr
Hillsboro, OH 45133-9751

Other NPIs with the same Medicare PAC ID 5

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

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
36D2161776Highland Health Providers Corporation11130 North Shore Drive, Hillsboro, OH 45133Certificate of waiverFeb 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
PFW Professional Servic8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

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
Amanda M Warix Individual W-2 Managing EmployeeExecutive Director Apr 1, 2019
Twana Zimmerman Individual Corporate DirectorBoard Member Oct 1, 2019
Elizabeth McNeal Individual Corporate DirectorBoard Member Jan 29, 2025
Timothy R Parry Individual Corporate DirectorBoard Member Jul 27, 2022
Denise Mootz Individual Corporate DirectorBoard Member Jan 29, 2025
India Chrisman Williams Individual Corporate OfficerBoard President Apr 1, 2019
Yolanda Moorman Individual Corporate DirectorBoard Member Mar 1, 2019
Bobbie Sampson Individual Corporate DirectorBoard Member Feb 24, 2021
Robert D McCray Individual Corporate DirectorBoard Member Jun 28, 2023
Jared M Warner Individual Corporate DirectorBoard Member Apr 1, 2019
Elizabeth B Miller Individual Corporate DirectorBoard Member Apr 1, 2019
Peggy Walker Rector Individual Corporate DirectorBoard Member Apr 1, 2019
Bryan Adam Smith Individual Corporate DirectorBoard Member Aug 31, 2022
Robert L Smith Individual Corporate OfficerBoard Secretary Apr 1, 2019

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1366906844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11130 NORTH SHORE DRIVE",
            "city": "HILLSBORO",
            "state": "OH",
            "postal_code": "45133",
            "telephone_number": "937-402-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11130 NORTH SHORE DRIVE",
            "city": "HILLSBORO",
            "state": "OH",
            "postal_code": "45133",
            "telephone_number": "937-402-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND HEALTH PROVIDERS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "ACKLEY",
        "authorized_official_first_name": "MEGHANN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "937-840-6617"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OH

Sources for this page

Verify at the official NPI Registry.