Butler County Community Health Consortium, Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Dayton, OH

NPI 1497316855 · NPPES record last updated Sep 29, 2025

Key facts

NPI
1497316855
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.
Practice address
165 E. Edwin C. Moses
Blvd
Dayton, OH 45402
Phone
(937) 535-5060
NPI assigned
Jun 26, 2019
Organization subpart
Yes
Parent organization (as reported)
BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM INC

Authorized official

Name
Stephen Roller
Title
Ceo
Phone
(513) 454-1460

Owners & managing parties with NPI records 1

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

Other NPIs on the same Medicare enrollment 18

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

Other NPIs with the same Medicare PAC ID 18

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

Corporate family (same tax ID) 24

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

Practitioners 78

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 78

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in OH

Federally qualified health center certification: CCN 721846

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 19, 2020
Last certification
Feb 19, 2020
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Nov 20, 2019 in OH
Enrollment address
165 S Edwin C Moses Blvd
Ste 100
Dayton, OH 45402-8472

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 Director
Trustee
Jan 1, 2024
Chad Creech
Individual
Corporate Director
President
Jan 1, 2024
Monica Scalf
Individual
Corporate Director
Trustee
Mar 1, 2026
Gustavo Cocina
Individual
Corporate Director
Trustee
Jan 1, 2020
William Andrew Groth
Individual
Corporate Director
Secretary
Jan 1, 2024
Samuel Broyles
Individual
Corporate Director
Trustee
Mar 1, 2026
Arvind Joshi
Individual
Corporate Director
Treasurer
Jan 1, 2024
Cynamon Trokhan
Individual
Corporate Director
Vice President
Jan 1, 2020
Sandra Rutledge
Individual
Corporate Director
Trustee
Jan 1, 2024
Ashley Banks
Individual
W-2 Managing Employee
Credentialing Specialist
Nov 25, 2019
Elizabeth Mohr
Individual
Corporate Officer
Cfo
Apr 20, 2026
Dennis Kidd
Individual
Corporate Director
Trustee
Jan 1, 2020
Stephen J Roller
Individual
Operational/Managerial Control
Ceo Owner
Jan 1, 2024
Michelle Miller
Individual
Corporate Director
Trustee
Jan 1, 2024

Medicare enrollment records

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
O20200221000428 OH Part a Provider - Federally Qualified Health Center (FQHC) 7810884780 Practice locations: Dayton, OH

National Provider Directory

Tax ID family
Butler County Community (129 organizations share this tax ID)
Part of
Butler County Community

Locations

300 Forest Ave
Dayton, OH 45405
Phone (937) 438-6465

300 High St
Hamilton, OH 45011

Specialties & licenses

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

Addresses

Primary practice location

165 E. Edwin C. Moses
Blvd
Dayton, OH 45402

Mailing address

PO Box 837
Hamilton, OH 45012-0837
Phone (513) 869-4917

Other names

  • Primary Health Solutions Doing business as

Other providers in Dayton, OH

All providers in Dayton, OH · Federally Qualified Health Center (FQHC) in Ohio

Sources for this page

Verify at the official NPI Registry.