NPIMap

Organization Active NPI

St Elizabeths Hospital of the Hospital Sisters of the Third Order

Doing business as HSHS St. Elizabeth's Hospital

  • Rehabilitation Hospital Unit
  • O'Fallon, IL
National Provider Identifier
1023097540
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Doing business as
HSHS St. Elizabeth's Hospital
Practice address
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone
(618) 234-2120
Fax
(618) 641-5486
NPI assigned
Jan 12, 2006
Organization subpart
Yes
Parent organization
HOSPITAL SISTERS HEALTH SYSTEMAs reported in NPPES

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
Mark D Evard
Title
VP of Revenue Cycle
Phone
(217) 492-9651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X IL Primary

Addresses

Primary practice location

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099

Mailing address

3051 Hollis Dr
Springfield, IL 62704-7450
Phone (618) 234-2120

Other identifiers 7

IdentifierTypeStateIssuer
0064066OtherBLUE CHOICE
010779908MedicaidMO
6701313OtherUHC METRAHEALTH
107847OtherHEALTHLINK
0914OtherMSBLUE CROSS
4489OtherGHP
0248OtherILBLUE CROSS

Other names 1

  • HSHS St. Elizabeth's Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hshs_st_elizabeth_ofallon2202617@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000629 IL Part B Supplier - Clinic/Group Practice 6406753011 Receives reassigned benefits from 38 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: O Fallon, IL

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Locations

180 S 3rd St
Ste 30
Belleville, IL 62220

2810 Frank Scott Pkwy W
Ste 824
Belleville, IL 62223

739 N Jefferson St
Mascoutah, IL 62258
Phone (618) 566-4900

3 Saint Elizabeth Blvd
Ste 3700
O Fallon, IL 62269
Phone (618) 607-5103

Interoperability endpoints

  • FHIR API: https://scripts.prevea.com/FHIR-ARR-PRD/api/FHIR/R4/

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1023097540",
    "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": "618-234-2120",
            "fax_number": "618-222-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT ELIZABETH BLVD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691099",
            "telephone_number": "618-234-2120",
            "fax_number": "618-641-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL SISTERS HEALTH SYSTEM",
        "enumeration_date": "2006-01-12",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "EVARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "217-492-9651"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "0064066",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010779908",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC METRAHEALTH",
            "identifier": "6701313",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "107847",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0914",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "4489",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0248",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hshs_st_elizabeth_ofallon2202617@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1 Saint Elizabeth Blvd",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HSHS St. Elizabeth's Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.