NPIMap

Organization Active NPI

Hamilton Center Inc.

Doing business as Grace Clinic Health Professional

  • Federally Qualified Health Center (FQHC)
  • Greencastle, IN
National Provider Identifier
1699558577
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HAMILTON CENTER INC.
Doing business as
Grace Clinic Health Professional
Practice address
239 Hillsdale Ave Ste a
Greencastle, IN 46135-1340
Phone
(812) 494-2215
NPI assigned
Aug 15, 2023
Last updated
Aug 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Melvin L Burks
Title
President/Ceo
Phone
(812) 231-8296

Specialties & licenses 1

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

Addresses

Primary practice location

239 Hillsdale Ave Ste a
Greencastle, IN 46135-1340

Mailing address

620 8TH Ave
Terre Haute, IN 47804-2744
Phone (812) 231-8438

Other names 1

  • Grace Clinic Health Professional Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201201002241 IN Part A Provider - Federally Qualified Health Center (FQHC) 4284533662 1 other NPI on this enrollment
Practice locations: Greencastle, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699558577. Details of each certification follow.

Federally qualified health center certification: CCN 151172

Legal name
HAMILTON CENTER, INC.
Doing business as
GRACE CLINIC HEALTH PROFESSIONAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 1, 2020
Last certification
Dec 1, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 27, 1967 in IN
Enrollment address
239 Hillsdale Ave
Ste a
Greencastle, IN 46135-1340

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Hamilton Center Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

620 8th Ave
Terre Haute, IN 47804
Phone (812) 231-8200

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Dana Guthrie Individual W-2 Managing Employee Jan 1, 2012
Melvin Burks Individual 5% Or Greater Direct Ownership Interest Jan 1, 2012
Corporate Director Jan 1, 2012
W-2 Managing EmployeeCeo Jan 1, 2012
Rick Stevens Individual Corporate OfficerBod President Jan 1, 2019
Robb a. Johnson Individual W-2 Managing EmployeeChief Operating Officer Jan 1, 2012
Yvonne Utley Individual W-2 Managing EmployeeCfo Jan 1, 2012
Tanya Michelle Baker Individual W-2 Managing EmployeeExec Dir Compliance Jan 1, 2012
Selena Cannady Individual W-2 Managing Employee Jan 1, 2012
Haley Ringwald Individual Corporate OfficerBod Secretary Jan 1, 2019

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hamilton Center, Inc.Terre Haute, IN, CCN 154009 Hospital Operational/Managerial Control (100%) Aug 25, 1967
Grace Clinic Health ProfessionalTerre Haute, IN, CCN 151083 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2012
Jan 1, 2012

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Hamilton Center Inc.

    dba Grace Clinic Health Professional

    • Federally Qualified Health Center (FQHC)
    • Terre Haute, IN
    • NPI 1205446259

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Hamilton Center, Inc.
    • Psychiatric Hospital
    • Terre Haute, IN
    • NPI 1578617627

    Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1699558577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 8TH AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042744",
            "telephone_number": "812-231-8438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 HILLSDALE AVE STE A",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461351340",
            "telephone_number": "812-494-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-15",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "BURKS",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "812-231-8296"
    },
    "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": "Grace Clinic Health Professional",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grace Clinic Health Professional",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greencastle, IN

Sources for this page

Verify at the official NPI Registry.