NPIMap

Organization Active NPI

St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

Doing business as Clinton County Rural Health

  • Rural Health Clinic/Center
  • Breese, IL
National Provider Identifier
1013002658
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE
Doing business as
Clinton County Rural Health
Practice address
9401 Holy Cross LN # 112
Breese, IL 62230-3510
Phone
(618) 526-7271
Fax
(618) 526-7313
NPI assigned
Oct 3, 2006
Last updated
Jan 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Authorized official

Name
Ann Bond
Title
System Director-Government Reimb
Phone
(217) 814-4586

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

9401 Holy Cross LN # 112
Breese, IL 62230-3510

Mailing address

3051 Hollis Dr
Springfield, IL 62704-7450
Phone (618) 526-7271

Other names 1

  • Clinton County Rural Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address st_josephs_breeze_toc2203120@ewd.direct.hshs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040217000493 IL Part B Supplier - Clinic/Group Practice 9638064892 Receives reassigned benefits from 57 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Breese, IL; Carlyle, IL
O20090521000178 IL Part A Provider - Rural Health Clinic 9638064892 Practice locations: Breese, IL
O20101215001188 IL Part A Provider - Hospital 9638064892 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Breese, IL; New Baden, IL; Carlyle, IL

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1013002658. Details of each certification follow.

Rural health clinic certification: CCN 148503

Legal name
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE
Doing business as
CLINTON COUNTY RURAL HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2009
Last certification
Mar 20, 2026
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 10, 1986 in IL
Enrollment address
9401 Holy Cross LN
# 112
Breese, IL 62230-3510
Related CCNs
140145

Hospital certification: CCN 140145

Legal name
ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE
Doing business as
ST. JOSEPH'S HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jul 2, 2016
Beds
96 (85 certified)
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1987 in IL
Enrollment address
9515 Holy Cross LN
Breese, IL 62230-3618
Main/Primary Hospital Location
Hospital subgroups
Acute care

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).

Other NPIs on the same Medicare enrollment 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
St Josephs HospitalCCN 140145 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
14D0676038Clinton County Rural Health Breese9401 Holy Cross Lane, Breese, IL 62230Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

9401 Holy Cross Ln
Breese, IL 62230
Phone (618) 526-5948

9401 Holy Cross Ln
#112
Breese, IL 62230
Phone (618) 526-7271

9401 Holy Cross Ln
Ste 112
Breese, IL 62230
Phone (618) 206-2082

11 N 1st St
New Baden, IL 62265
Phone (618) 588-9889

Networks

  • IL HMO

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Anna T Phiri Individual Corporate DirectorBoard Member Jul 19, 2021
Daniel C Imming Individual Corporate DirectorBoard Member Jan 1, 2024
Jeffery Sterling Individual Corporate OfficerVice President- Managed Care Jun 1, 2025
W-2 Managing EmployeeVice President- Managed Care Jun 1, 2025
Dennis E Middendorff Individual Corporate Director Nov 1, 2022
Tracy L Millard Individual Corporate DirectorVice Chairperson May 1, 2026
Corporate Director Nov 1, 2022
Hospital Sisters Services Inc Organization, Springfield, IL Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
5% Or Greater Direct Ownership Interest Dec 29, 1987 100%
Kurt Rickoff Individual Corporate DirectorBoard Member May 1, 2026
KC Strieker Individual Corporate DirectorBoard Member May 1, 2026
Ann E Doll-Pollard Individual Corporate DirectorBoard of Director Member Nov 1, 2018
Tom Frerker Individual Corporate DirectorBoard of Director Member Nov 1, 2018
Amanda Ennen Individual Corporate OfficerPresident & Ceo Jun 1, 2025
Paige Toth Individual Corporate DirectorSecretary Oct 29, 2025
Megan a Holtmann Individual Corporate DirectorChairperson May 1, 2026
Corporate DirectorBoard Member Jan 1, 2024
Ann Bond Individual Corporate DirectorSystem Director Oct 29, 2025
Richelle Rennegarbe Individual Corporate DirectorChairperson Oct 29, 2025
Chris Klay Individual Corporate OfficerPresident & Ceo Jun 1, 2025
John Fridley Individual Corporate DirectorBoard of Director Member Nov 1, 2018

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
St. Joseph's Hospital-BreeseCarlyle, IL, CCN 148570 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 30, 1978

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

Affiliated clinicians 303

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

View all 303

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1013002658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450",
            "telephone_number": "618-526-7271",
            "fax_number": "618-526-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 HOLY CROSS LN # 112",
            "city": "BREESE",
            "state": "IL",
            "postal_code": "622303510",
            "telephone_number": "618-526-7271",
            "fax_number": "618-526-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR-GOVERNMENT REIMB",
        "authorized_official_telephone_number": "217-814-4586"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "st_josephs_breeze_toc2203120@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9515 Holy Cross Ln",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clinton County Rural Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinton County Rural Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Breese, IL

Sources for this page

Verify at the official NPI Registry.