Hamilton Community Health Network Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Clio, MI
NPI 1922245299 · NPPES record last updated Jan 8, 2021
Key facts
- NPI
- 1922245299
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- HAMILTON COMMUNITY HEALTH NETWORK INC.
- Practice address
- 4154 W Vienna Rd
Clio, MI 48420-2809 - Phone
- (810) 687-1008
- Fax
- (810) 687-1951
- NPI assigned
- Jan 8, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Clarence R. Pierce, MSA
- Title
- Ceo
- Phone
- (810) 406-4912
Owners & managing parties with NPI records 1
-
David Alan Bloom, MD
Owned or controlled facilities with NPI records 3
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 9
Corporate family (same tax ID) 15
Practitioners 48
-
Paholo Graziano Barboglio Romo, MD, MPH
-
Elaine Boyle, P.A.-C
-
Joseph R Burtch, DO
-
Brandi Jonee Buskirk, PA-C
-
Benjamin James Busuito, PA-C
-
Stephanie Cates, MSW
-
Huda M Elhwairis, M.D.
-
Krister Engja, PA-C
-
Keran Eudora Ernest, LMSW
-
Michael Giacalone Jr., M.D.
-
Keow Mei Goh, M.D.
-
David Hamaker, PA-C
-
Karen Hassell, FNP-BC, PMHNP-BC
-
Lindsey Allison Herrel, M.D.
-
Abbey Hilden, PA-C
-
Pamela Hopkins, AGNP
-
Nirlep Kaur, NP
-
Tonya Mary Lott, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1042770 | Hamilton Community Health Network Inc | Provider-performed microscopy | Jul 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Federally qualified health center certification: CCN 231940
- Legal name
- HAMILTON COMMUNITY HEALTH NETWORK INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 10, 2009
- Last certification
- Mar 10, 2009
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Incorporated
- Apr 2, 1982 in MI
- Enrollment address
- 4154 W Vienna Rd
Clio, MI 48420-2809
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Christine Gleason |
Corporate Officer |
Oct 1, 2011 | |
| Clarence R. Pierce |
Corporate Officer |
May 30, 2006 | 100% |
| Corporate Director |
May 30, 2006 | 100% | |
| W-2 Managing Employee |
May 30, 2006 | ||
| Operational/Managerial Control |
May 30, 2009 | 100% | |
| David Bloom |
Corporate Officer |
Jan 16, 2016 | |
| Stephanie Simmons |
Corporate Officer |
Jan 16, 2016 | |
| Archie Leflore |
Corporate Officer |
Jul 1, 1982 | |
| Nancy Rich |
Corporate Officer |
Nov 1, 2003 | |
| Ronald Stamps |
Corporate Officer |
Dec 1, 2008 | |
| Michael Townsend |
Corporate Officer |
Nov 1, 2011 | |
| Gloria Quinney |
Corporate Officer |
Jan 1, 1999 | |
| Henry Hatter |
Corporate Officer |
Apr 1, 2000 | |
| George Wilkinson |
Corporate Officer |
Jan 16, 2016 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Hamilton Community Health Network Inc |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jul 1, 1983 |
| Hamilton Community Health Network, Inc. |
Federally qualified health center | Operational/Managerial Control | Apr 1, 2024 |
| Hamilton Community Health Network Inc |
Federally qualified health center | Operational/Managerial Control | Aug 10, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090113000669 | MI | Part a Provider - Federally Qualified Health Center (FQHC) | 1254249196 |
1 other NPI on this enrollment Practice locations: Clio, MI |
National Provider Directory
- Tax ID family
- Hamilton Community Health Network Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
4154 W Vienna Rd
Clio, MI 48420-2809
Mailing address
225 E 5TH St
Suite 300
Flint, MI 48502-1641
Phone (810) 406-4912
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23-1940 | Other | MI | MEDICARE PART A |
Other providers in Clio, MI
- Victoria Geren
- Grace Haven
- Michael Greshock
- Gross Adult Foster Care Inc
- Susan Lynn Hall
- Hamilton Spinal Care Center LLC
- Aaron Hanchett
- Beverly Harris
- Haley Cristina Hart
- Karen Hassell
All providers in Clio, MI · Federally Qualified Health Center (FQHC) in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.