Franklin Hospital District
Organization Active NPI Rural Health Clinic/Center · Benton, IL
NPI 1033140488 · NPPES record last updated Feb 25, 2019
Key facts
- NPI
- 1033140488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FRANKLIN HOSPITAL DISTRICT
- Practice address
- 201 Bailey Lane
Benton, IL 62812-0000 - Phone
- (618) 439-3161
- Fax
- (618) 439-4049
- NPI assigned
- Jul 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Rikki Bonthron
- Title
- Cfo
- Phone
- (618) 439-3161
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 4
Related certifications (CCN) 1
Practitioners 35
-
Jason Dorris, PA-C
-
Allison Anne Frost, FNP-C
-
John D Hartman, MD
-
Jeanne E. Holdren, APN
-
Brooke Hudson, FNP
-
Richard Rethorst, MD
-
Jennifer Little, NP
-
Heather Rae Ward, APN
-
Darla Joe Allan, NP-C
-
Danielle Butler, PA-C
-
Katlyn Carrier, PA-C
-
Vadzim Chyzhyk, MD
-
Jayna Lynne Cowsert, PA-C
-
Brandon Cole Edwards, NP-C
-
Joseph G Huber, NP
-
Jennifer N Isom, LCPC
-
Joshua Caleb Loyd, FNP-BC
-
Melinda Beth Moore, DPM
-
Anand K Patel, M.D.
-
Ashlyn Peebles, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Rural health clinic certification: CCN 143469
- Legal name
- FRANKLIN HOSPITAL DISTRICT
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 6, 2005
- Last certification
- Mar 5, 2025
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Incorporated
- Sep 25, 1950 in IL
- Enrollment address
- 201 Bailey LN
Benton, IL 62812-1969 - Related CCNs
- 141321
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| James M Johnson |
Corporate Officer |
Jul 1, 2016 | |
| Operational/Managerial Control |
Jul 1, 2016 | ||
| Rikki Bonthron |
Corporate Officer |
Jun 5, 2005 | |
| Gayla Kain |
Corporate Director |
Aug 10, 2014 | |
| Keith Ing |
Corporate Director |
Sep 1, 2019 | |
| Robert Lewis |
Corporate Director |
Aug 9, 2013 | |
| Jim Johnson |
Corporate Director |
Sep 15, 2016 | |
| Brent Young |
Corporate Director |
Aug 20, 2012 | |
| Ron Knox |
Corporate Director |
Aug 24, 2021 | |
| Don Cruz |
Corporate Director |
Sep 1, 2017 | |
| Royann Wilson |
Corporate Director |
Aug 24, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050531000098 | IL | Part a Provider - Rural Health Clinic | 4082516042 | Practice locations: Benton, IL |
National Provider Directory
- Tax ID family
- Franklin Hospital
Locations
203 Bailey Ln
Ste 2B
Benton, IL 62812
Interoperability endpoints
- https://fhir.yourcareuniverse.net/tenant/c680de42-53d4-410c-a755-e5a226565d34
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
201 Bailey Lane
Benton, IL 62812-0000
Mailing address
201 Bailey Lane
Benton, IL 62812-0000
Phone (618) 439-3161
Other names
- FAMILY HEALTHCARE CLINIC
Other providers in Benton, IL
- Pamela Kay Edmonds
- Kent Edwards
- Marcia Ellison
- Jessica Etienne
- Sheila Murphy Foster
- Franklin Hospital District
- Franklin Hospital District
- Franklin Hospital District
- Franklin Jefferson Co SP Ed
- Freds Stores of Tennessee Inc
All providers in Benton, IL · Rural Health Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2019. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.