NPIMap

Organization Active NPI

Hillsdale Community Health Center

  • Psychiatric Hospital Unit
  • Hillsdale, MI
National Provider Identifier
1750455168
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
HILLSDALE COMMUNITY HEALTH CENTER
Practice address
168 S Howell St
Hillsdale, MI 49242
Phone
(517) 437-4451
Fax
(517) 437-0246
NPI assigned
Nov 17, 2006
Last updated
Jul 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Authorized official

Name
Mr. Mark Gross
Title
Chief Financial Officer
Phone
(517) 437-5232

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary
Clinical Social Worker 1041C0700X MI

Addresses

Primary practice location

168 S Howell St
Hillsdale, MI 49242

Mailing address

168 S Howell St
Hillsdale, MI 49242-2040
Phone (517) 437-4451

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070110000439 MI Part A Provider - Hospital 7214846260 Practice locations: Hillsdale, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750455168. Details of each certification follow.

Hospital certification: CCN 23S037

Legal name
HILLSDALE COMMUNITY HEALTH CENTER
Doing business as
HILLSDALE HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Feb 21, 1940 in MI
Enrollment address
168 S Howell St
Hillsdale, MI 49242-2040
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Hillsdale Community Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Mark a Gross Individual Corporate OfficerCfo May 22, 2024
Sarah Lee Butler Individual W-2 Managing EmployeeBhu Manager Mar 1, 2016 100%
David D Gossage Individual Corporate Director Nov 9, 2010
Gregory Bailey Individual Corporate Director Nov 9, 2010
Robert Henthorne Individual Corporate Director Nov 9, 2010
Karlye Horton Individual Corporate DirectorBoard Member Nov 1, 2018
Craig Connor Individual Corporate Director Nov 9, 2010
Shea Dow Individual Corporate DirectorBoard Member Jan 25, 2024
Kimberly Blythe Individual Corporate DirectorBoard Member Dec 1, 2015
Jeremiah Hodshire Individual Corporate DirectorPresident / Ceo Apr 30, 2021 100%
Diane Philipp Individual Corporate DirectorBoard Member Jan 1, 2009
Susan Mary Smith Individual Corporate DirectorBoard Member Feb 25, 2021
Richard Moore Individual Corporate Director Oct 1, 2011

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hillsdale Health & WellnessHillsdale, MI, CCN 238725 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 18, 2019

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530748800000",
    "number": "1750455168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 S HOWELL ST",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492422040",
            "telephone_number": "517-437-4451",
            "fax_number": "517-437-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 S HOWELL ST",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "49242",
            "telephone_number": "517-437-4451",
            "fax_number": "517-437-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSDALE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-07-05",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "517-437-5232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.