NPIMap

Organization Active NPI

Hills & Dales General Hospital, Inc.

  • Rural Health Clinic/Center
  • Kingston, MI
National Provider Identifier
1457570574
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HILLS & DALES GENERAL HOSPITAL, INC.
Practice address
5854 State St
Kingston, MI 48741-9524
Phone
(989) 683-8065
Fax
(989) 683-8088
NPI assigned
Apr 25, 2007
Organization subpart
Yes
Parent organization
HILLS & DALES GENERAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Authorized official

Name
Kenneth E Baranski, CFO
Title
Chief Financial Officer
Phone
(989) 912-6225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

5854 State St
Kingston, MI 48741-9524

Mailing address

4675 Hill St
Cass City, MI 48726-1008
Phone (989) 912-6185

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131016002000 MI Part A Provider - Rural Health Clinic 8022910363 Practice locations: Kingston, MI

Rural health clinic certification: CCN 238670

Legal name
HILLS & DALES GENERAL HOSPITAL INC
Doing business as
KINGSTON FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 8, 2014
Last certification
Jan 8, 2014
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 1, 1960 in MI
Enrollment address
5854 State St
Kingston, MI 48741-9524
Related CCNs
231316

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

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
23D0958965Kingston Family Practice5854 State Street, Kingston, MI 48741Certificate of waiverApr 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
Hills Dales General H34 organizations share this tax ID, including this one
Part of
Hills Dales General H

Other organizations with this tax ID 33

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

View all 33

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Carol L Starling Individual Corporate OfficerBoard Member Feb 26, 2019
Faith Ann Fahrner Individual Corporate OfficerBoard Member Feb 26, 2019
Patrick D Curtis Individual Corporate DirectorBoard Member Jan 1, 2010
Kimberly Gentner Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing EmployeeCfo Jan 1, 2024
Steven Ellis Individual Corporate OfficerBoard Member Jan 1, 2024
Victoria Meiburg Individual Corporate OfficerBoard Member Jan 1, 2024
Gail Ann Denton Individual Corporate OfficerBoard Member Jan 1, 2024
Judy K Brown Individual Corporate DirectorBoard Member Jan 1, 2011
Angela McConnachie Individual Corporate OfficerCo-Ceo Jan 1, 2024
W-2 Managing EmployeeCo-Ceo Jan 1, 2024
Scott Orr Individual Corporate OfficerBoard Member Jan 1, 2024
Andrew Joseph Daniels Individual Corporate OfficerCeo Jan 1, 2022
Corporate DirectorCeo Jan 1, 2022
W-2 Managing EmployeeCeo Jan 1, 2022
David Messing Individual Corporate OfficerBoard Member Jan 1, 2024

Owners & managing parties with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1457570574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 HILL ST",
            "city": "CASS CITY",
            "state": "MI",
            "postal_code": "487261008",
            "telephone_number": "989-912-6185",
            "fax_number": "989-912-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5854 STATE ST",
            "city": "KINGSTON",
            "state": "MI",
            "postal_code": "487419524",
            "telephone_number": "989-683-8065",
            "fax_number": "989-683-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLS & DALES GENERAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HILLS & DALES GENERAL HOSPITAL, INC.",
        "enumeration_date": "2007-04-25",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "BARANSKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "989-912-6225",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, MI

Sources for this page

Verify at the official NPI Registry.