NPIMap

Organization Active NPI

Knox County General Health District

  • Federally Qualified Health Center (FQHC)
  • Danville, OH
National Provider Identifier
1760955975
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
KNOX COUNTY GENERAL HEALTH DISTRICT
Practice address
12 East Main Street
Danville, OH 43014
Phone
(740) 392-2200
Fax
(740) 392-9613
NPI assigned
Jan 10, 2019
Organization subpart
Yes
Parent organization
KNOX COUNTY GENERAL HEALTH DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Authorized official

Name
Zach Green
Title
Health Commissioner
Phone
(740) 392-2200

Specialties & licenses 1

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

Addresses

Primary practice location

12 East Main Street
Danville, OH 43014

Mailing address

11660 Upper Gilchrist Rd
Mount Vernon, OH 43050-9084
Phone (740) 392-2200

Other identifiers 1

IdentifierTypeStateIssuer
0216583MedicaidOH

Other names 1

  • Danville Community Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200130002591 OH Part A Provider - Federally Qualified Health Center (FQHC) 8820078595 Practice locations: Danville, OH

Federally qualified health center certification: CCN 721843

Legal name
KNOX COUNTY GENERAL HEALTH DISTRICT
Doing business as
DANVILLE COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 30, 2020
Last certification
Jan 30, 2020
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
12 E Main St
Danville, OH 43014

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Knox County Board of MRDD10 organizations share this tax ID, including this one
Part of
Knox County Board of MRDD

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Jason Whaley Individual Corporate OfficerPresident Pro Tempore of the Boa Jul 1, 2022
Zachary Green Individual Corporate OfficerSecretary of the Board of Health Jul 1, 2022
W-2 Managing EmployeeHealth Commissioner Jul 1, 2022
Jeff Harmer Individual Corporate OfficerPresident of the Board of Health Jul 1, 2022
Knox County General Health District Organization, Danville, OH 5% Or Greater Direct Ownership Interest Nov 18, 2019 100%

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Knox County Community Health CenterMount Vernon, OH, CCN 361130 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2017
Knox County DentalDanville, OH, CCN 721883 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 11, 2021
Kcchc Walk-in ClinicMount Vernon, OH, CCN 721964 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)		 Jan 1, 2022
Jan 1, 2022
Behavioral Health of Mount Vernon Health CenterMount Vernon, OH, CCN 721977 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)		 Jan 1, 2022
Jan 1, 2022
Mount Vernon Health CenterMount Vernon, OH, CCN D21026 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2024
Jan 1, 2024
Centerburg Health CenterCenterburg, OH, CCN D21104 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2025

Owned or controlled facilities with NPI records 6

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

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1760955975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 UPPER GILCHRIST RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430509084",
            "telephone_number": "740-392-2200",
            "fax_number": "740-392-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EAST MAIN STREET",
            "city": "DANVILLE",
            "state": "OH",
            "postal_code": "43014",
            "telephone_number": "740-392-2200",
            "fax_number": "740-392-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNOX COUNTY GENERAL HEALTH DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KNOX COUNTY GENERAL HEALTH DISTRICT",
        "enumeration_date": "2019-01-10",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ZACH",
        "authorized_official_title_or_position": "HEALTH COMMISSIONER",
        "authorized_official_telephone_number": "740-392-2200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0216583",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Danville Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, OH

Sources for this page

Verify at the official NPI Registry.