NPIMap

Organization Active NPI

Butler County Community Health Consortium, Inc.

  • Federally Qualified Health Center (FQHC)
  • Trenton, OH
National Provider Identifier
1629618681
Registry record updated Nov 3, 2023
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.
Practice address
3045 Busenbark Rd Ste B
Trenton, OH 45067-7611
Phone
(513) 454-1111
NPI assigned
Jan 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 1

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

Addresses

Primary practice location

3045 Busenbark Rd Ste B
Trenton, OH 45067-7611

Mailing address

PO Box 837
Hamilton, OH 45012-0837
Phone (513) 454-1460

Other names 1

  • Primary Health Solutions Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandi.ballantyne.p5@direct.phs.nextgenshare.com

Medicare participation

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

Enrollment records 2

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
O20200713002438 OH Part A Provider - Federally Qualified Health Center (FQHC) 7810884780 Practice locations: Trenton, OH

Federally qualified health center certification: CCN 721863

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
Oct 13, 2020
Last certification
Oct 13, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 2009 in OH
Enrollment address
3045 Busenbark Rd
Ste B
Trenton, OH 45067-7611

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

Other NPIs on the same Medicare enrollment 18

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

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 Corporate DirectorTrustee Jan 1, 2024
Chad Creech Individual Corporate DirectorPresident Jan 1, 2024
Monica Scalf Individual Corporate DirectorTrustee Mar 1, 2026
Gustavo Cocina Individual Corporate DirectorTrustee Jan 1, 2020
William Andrew Groth Individual Corporate DirectorTreasurer Jan 1, 2020
Samuel Broyles Individual Corporate DirectorTrustee Mar 1, 2026
Arvind Joshi Individual Corporate DirectorTreasurer Jan 1, 2024
Cynamon Trokhan Individual Corporate DirectorVice President Jan 1, 2020
Sandra Rutledge Individual Corporate DirectorTrustee Jan 1, 2024
Ashley Banks Individual W-2 Managing EmployeeCredentialing Specialist Nov 25, 2019
Elizabeth Mohr Individual Corporate OfficerCfo Apr 20, 2026
Dennis Kidd Individual Corporate DirectorTrustee Jan 1, 2020
Stephen J Roller Individual Operational/Managerial ControlCeo Owner Jan 1, 2024
Michelle Miller Individual Corporate DirectorTrustee 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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1629618681",
    "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": "513-454-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 BUSENBARK RD STE B",
            "city": "TRENTON",
            "state": "OH",
            "postal_code": "450677611",
            "telephone_number": "513-454-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER COUNTY COMMUNITY HEALTH CONSORTIUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "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": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandi.ballantyne.p5@direct.phs.nextgenshare.com",
            "affiliation": "N",
            "address_1": "3045 Busenbark Rd Ste B",
            "city": "Trenton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450677611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Primary Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Primary Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trenton, OH

Sources for this page

Verify at the official NPI Registry.