NPIMap

Organization Active NPI

Healthlinc, Inc

  • Community Health Clinic/Center
  • Elkhart, IN
National Provider Identifier
1720033418
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
HEALTHLINC, INC
Practice address
236 Simpson Ave
Elkhart, IN 46516-4666
Phone
(574) 970-1435
Fax
(574) 970-3255
NPI assigned
May 23, 2006
Last updated
Oct 6, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTHLINC, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Authorized official

Name
Melissa Mitchell
Title
Ceo
Phone
(219) 413-5100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X IN Primary
Federally Qualified Health Center (FQHC) 261QF0400X NU

Addresses

Primary practice location

236 Simpson Ave
Elkhart, IN 46516-4666

Mailing address

236 Simpson Ave
Elkhart, IN 46516-4666
Phone (574) 970-7954

Other identifiers 1

IdentifierTypeStateIssuer
100097610AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040105000515 IN Part B Supplier - Clinic/Group Practice 9931008380 Receives reassigned benefits from 46 practitioners
Practice locations: Elkhart, IN
O20071116000462 IN Part A Provider - Federally Qualified Health Center (FQHC) 9931008380 Practice locations: Elkhart, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720033418. Details of each certification follow.

Federally qualified health center certification: CCN 151821

Legal name
HEART CITY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 20, 2000
Last certification
Nov 20, 2000
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 26, 1993 in IN
Enrollment address
236 Simpson Ave
Elkhart, IN 46516-4666

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Heart City Health Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Martina Green-McGowan Individual Corporate OfficerDeputy Chief Medical Officer Jan 30, 2016
Operational/Managerial ControlDeputy Chief Medical Officer Jan 30, 2016
Lalaesha Black Individual Corporate OfficerCeo Feb 28, 2025
Mildred Herendeen Individual Corporate DirectorBoard Member Aug 22, 2018
Angelia Washington Individual Corporate DirectorBoard Member Feb 2, 2017
Arvis Dawson Individual Corporate DirectorBoard Member Oct 7, 2017
Esleen Fultz Individual Corporate OfficerCeo Jan 1, 2017
Operational/Managerial ControlCeo Jan 1, 2017
Robert Taylor Individual Corporate DirectorBoard Member Feb 28, 2018
Amanda Pietsch Individual Corporate OfficerCfo Jun 9, 2025
Rod Roberson Individual Corporate DirectorBoard Member Oct 1, 2010
Anthony Hunt Individual Corporate DirectorBoard Member Jan 2, 2014
Anthony England Individual Corporate DirectorBoard Member Mar 28, 2018
Tara Morris Individual Corporate DirectorBoard Member Sep 3, 2015

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 49

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 49

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1720033418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 SIMPSON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465164666",
            "telephone_number": "574-970-7954",
            "fax_number": "574-970-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 SIMPSON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465164666",
            "telephone_number": "574-970-1435",
            "fax_number": "574-970-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHLINC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTHLINC, INC",
        "enumeration_date": "2006-05-23",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-413-5100"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "IN",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100097610A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.