NPIMap

Organization Active NPI

Hamilton Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Harrisburg, PA
National Provider Identifier
1568089654
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HAMILTON HEALTH CENTER, INC
Practice address
895 S Arlington Ave
Harrisburg, PA 17109-5004
Phone
(717) 232-9971
NPI assigned
Jul 6, 2020
Last updated
Jul 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Eric Christopher Blum
Title
Cfo
Phone
(717) 230-3971

Specialties & licenses 1

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

Addresses

Primary practice location

895 S Arlington Ave
Harrisburg, PA 17109-5004

Mailing address

110 S 17TH St
Harrisburg, PA 17104-1123
Phone (717) 232-9971

Other names 2

  • 895 Arlington Other name
  • 895 Arlington Ave Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201116000866 PA Part A Provider - Federally Qualified Health Center (FQHC) 0042119547 Practice locations: Harrisburg, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568089654. Details of each certification follow.

Federally qualified health center certification: CCN 391186

Legal name
HAMILTON HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 13, 2020
Last certification
Nov 13, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
895 S Arlington Ave
Harrisburg, PA 17109-5004

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Hamilton Health Center Downey11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Hamilton Health Center, Inc. Organization, Harrisburg, PA Corporation Operational/Managerial Control Oct 1, 2017 100%
Other Apr 1, 2025
Danita Henson Individual W-2 Managing EmployeeSr Director of Patient Access Mar 1, 2022 100%
Terese McIntyre-Delaplaine Individual Corporate OfficerCeo & President Jan 1, 2022

Owners & managing parties with NPI records 5

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": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1568089654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 17TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041123",
            "telephone_number": "717-232-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 S ARLINGTON AVE",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171095004",
            "telephone_number": "717-232-9971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "717-230-3971"
    },
    "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": "895 Arlington",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "895 Arlington Ave",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.