NPIMap

Organization Active NPI

Butler County Community Health Consortium, Inc.

Doing business as Primary Health Solutions

  • Federally Qualified Health Center (FQHC)
  • Middletown, OH
National Provider Identifier
1528828696
Registry record updated Feb 6, 2025
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.
Doing business as
Primary Health Solutions
Practice address
930 9TH Ave
Middletown, OH 45044-5530
Phone
(513) 454-1111
Fax
(513) 737-1592
NPI assigned
Mar 19, 2024
Last updated
Feb 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

930 9TH Ave
Middletown, OH 45044-5530

Mailing address

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

Other names 1

  • PRIMARY HEALTH SOLUTIONS Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240710000789 OH Part A Provider - Federally Qualified Health Center (FQHC) 7810884780 Practice locations: Middletown, OH
O20241009003891 OH Part B Supplier - Clinic/Group Practice 7810884780 Receives reassigned benefits from 2 practitioners
Practice locations: Middletown, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528828696. Details of each certification follow.

Federally qualified health center certification: CCN D21042

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
Jul 10, 2024
Last certification
Jul 10, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 2, 2004 in OH
Enrollment address
930 9TH Ave
Middletown, OH 45044-5530

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

National Provider Directory

National Provider Directory
Tax ID family
Butler County Community129 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

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 OtherTrustee Jan 1, 2024
Chad Creech Individual Corporate DirectorPresident Jan 1, 2024
Monica Scalf Individual Corporate DirectorTrustee Mar 1, 2026
Gustavo Cocina Individual OtherTrustee Jan 1, 2024
William Andrew Groth Individual Corporate DirectorSecretary Mar 1, 2026
Samuel Broyles Individual Corporate DirectorTrustee Mar 1, 2026
Arvind Joshi Individual Corporate DirectorTreasurer Jan 1, 2024
Cynamon Trokhan Individual Corporate DirectorVice President Jan 1, 2024
Sandra Rutledge Individual Corporate DirectorTrustee Mar 1, 2026
Ashley Banks Individual W-2 Managing EmployeeCredentialing Specialist Jan 1, 2024
Elizabeth Mohr Individual Corporate OfficerCfo Apr 20, 2026
Dennis Kidd Individual OtherTrustee Jan 1, 2024
Stephen J Roller Individual Corporate OfficerCeo Jan 1, 2024
Michelle Miller Individual OtherTrustee 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.

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1528828696",
    "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": "513-869-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 9TH AVE",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450445530",
            "telephone_number": "513-454-1111",
            "fax_number": "513-737-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "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": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMARY HEALTH SOLUTIONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.