NPIMap

Organization Active NPI

Hillsboro Area Hospital, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Hillsboro, IL
National Provider Identifier
1003896499
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
0000968 Issued in IL
Legal business name
HILLSBORO AREA HOSPITAL, INC.
Practice address
1200 E Tremont St
Hillsboro, IL 62049-1912
Phone
(217) 532-6111
Fax
(217) 532-2726
NPI assigned
Jan 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Terri L Carroll
Title
Vice President of Financial Service
Phone
(217) 532-4187

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 0000968 IL Primary

Addresses

Primary practice location

1200 E Tremont St
Hillsboro, IL 62049-1912

Mailing address

1200 E Tremont St
Hillsboro, IL 62049-1912
Phone (217) 532-6111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080314000089 IL Part A Provider - Critical Access Hospital 4486547148 Receives reassigned benefits from 10 practitioners
Practice locations: Hillsboro, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003896499. Details of each certification follow.

Hospital certification: CCN 14Z332

Legal name
HILLSBORO AREA HOSPITAL, INC.
Organization structure
CorporationNon-profit
Incorporated
Apr 3, 1906 in IL
Enrollment address
1200 E Tremont St
Hillsboro, IL 62049-1912
Hospital Swing-Bed Unit

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

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
Hillsboro Hosp Ultrasou7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Michael Alexander Individual Contracted Managing EmployeeChief Executive Officer Apr 17, 2023
Corporate OfficerChief Executive Officer Apr 17, 2023
Ashley Smith Individual Corporate OfficerVP of Quality and Support Jan 1, 2022
W-2 Managing EmployeeVP of Quality and Support Jan 1, 2022
Julie Jenkins Individual Corporate Director Oct 18, 2012
Kimberly Clevenger Individual W-2 Managing EmployeeCredentialing Specialist Feb 6, 2023
Mary Herschelman Individual Corporate Director Oct 20, 2022
James Hertel Individual Corporate Director Oct 21, 2021
Hillsboro Area Hospital System NFP Organization, Hillsboro, IL Non-profit Operational/Managerial Control Aug 26, 2003
Earl Flack Individual Corporate Director May 10, 2018
Joseph a Blaser Individual Corporate Director Mar 16, 2023
Jordan Ruppert Individual Corporate Director May 10, 2018
Benjamin W Cady Individual Corporate Director Oct 18, 2012
Lisa White Individual Corporate Director Oct 15, 2020
Misty Borrowman Individual Corporate Director Oct 15, 2020
Alexander Nazarian Individual Corporate OfficerCfo Apr 22, 2024
W-2 Managing EmployeeCfo Apr 22, 2024
Operational/Managerial ControlCfo Apr 22, 2024

Owners & managing parties with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003896499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E TREMONT ST",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620491912",
            "telephone_number": "217-532-6111",
            "fax_number": "217-532-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E TREMONT ST",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620491912",
            "telephone_number": "217-532-6111",
            "fax_number": "217-532-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSBORO AREA HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCIAL SERVICE",
        "authorized_official_telephone_number": "217-532-4187"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IL",
            "license": "0000968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, IL

Sources for this page

Verify at the official NPI Registry.