NPIMap

Organization Active NPI

Hillsdale Community Health Center

  • Rural Health Clinic/Center
  • Hillsdale, MI
National Provider Identifier
1801618608
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HILLSDALE COMMUNITY HEALTH CENTER
Practice address
1456 Hudson Rd
Hillsdale, MI 49242-8314
Phone
(517) 439-0200
NPI assigned
Oct 31, 2024
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Jeremiah Jason Hodshire
Title
President/Ceo
Phone
(517) 437-5141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1456 Hudson Rd
Hillsdale, MI 49242-8314

Mailing address

168 S Howell St
Hillsdale, MI 49242-2081
Phone (517) 437-4451

Other names 1

  • Hillsdale Medical Associates Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040805000518 MI Part B Supplier - Clinic/Group Practice 7214846260 Receives reassigned benefits from 121 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hillsdale, MI; Reading, MI
O20241217002176 MI Part A Provider - Rural Health Clinic 7214846260 Practice locations: Hillsdale, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801618608. Details of each certification follow.

Rural health clinic certification: CCN 238778

Legal name
HILLSDALE COMMUNITY HEALTH CENTER
Doing business as
HILLSDALE MEDICAL ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 29, 2024
Last certification
Oct 19, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1456 Hudson Rd
Hillsdale, MI 49242-8314
Related CCNs
230037

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).

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0669974Hillsdale Medical Associates - RHC1456 S Hudson Road, Hillsdale, MI 49242Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Hillsdale Comm Health C6 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 12

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

NameRoleSinceShare
David D Gossage Individual Corporate DirectorBoard Member Jan 1, 2010
Seth Gibson Individual W-2 Managing EmployeeAd; Aug 1, 2019
Gregory Bailey Individual Corporate DirectorBoard Member Jan 1, 1996
Robert Henthorne Individual Corporate DirectorBoard Member Oct 1, 2009
Karlye Horton Individual Corporate DirectorBoard Member Dec 1, 2018
Craig Connor Individual Corporate DirectorBoard Member Jan 1, 2008
Shea Dow Individual Corporate DirectorBoard Member Jan 1, 2024
Kimberly Blythe Individual Corporate DirectorBoard Member Dec 1, 2015
Jeremiah Hodshire Individual Corporate OfficerCeo/President Jun 1, 2020 100%
W-2 Managing EmployeeCeo/President May 10, 2010 100%
Diane Philipp Individual Corporate DirectorBoard Member Jan 1, 2009
Susan Mary Smith Individual Corporate DirectorBoard Member Feb 1, 2021
Richard Moore Individual Corporate DirectorBoard Member Oct 1, 2011

Owners & managing parties with NPI records 1

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.

Change-of-ownership history 1

DateEventCounterparty
Oct 29, 2024 Change of OwnershipThis provider was the buyer Hillsdale Medical Associates, PLCCCN 233845, MI, NPI 1902841208

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 5

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": "1730332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1801618608",
    "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": "492422081",
            "telephone_number": "517-437-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 HUDSON RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492428314",
            "telephone_number": "517-439-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSDALE COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "HODSHIRE",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "517-437-5141"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsdale Medical Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.