NPIMap

Organization Active NPI

Illinois Department of Human Services

Doing business as Alton Mental Health Center

  • Psychiatric Hospital
  • Alton, IL
National Provider Identifier
1083620827
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Doing business as
Alton Mental Health Center
Practice address
4500 College Ave
Alton, IL 62002
Phone
(618) 474-3800
NPI assigned
Aug 1, 2006
Last updated
Aug 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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

Authorized official

Name
Tonya Piephoff
Title
Hospital Administrator
Phone
(618) 474-3473

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

4500 College Ave
Alton, IL 62002

Mailing address

4500 College Ave
Alton, IL 62002-5051

Other identifiers 1

IdentifierTypeStateIssuer
000194572001MedicaidIL

Other names 1

  • Alton Mental Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031113000414 IL Part B Supplier - Clinic/Group Practice 9830003920 Receives reassigned benefits from 43 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Centralia, IL; Waukegan, IL; Park Forest, IL; Kankakee, IL; Hines, IL; Dwight, IL; Dixon, IL; Chicago, IL…
O20080415000382 IL Part A Provider - Hospital 9830003920 Practice locations: Alton, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083620827. Details of each certification follow.

Hospital certification: CCN 144016

Legal name
ILLINOIS DEPARTMENT OF HUMAN SERVICES
Doing business as
ALTON MENTAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Jul 31, 2019
Beds
24
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
4500 College Ave
Alton, IL 62002-5051
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 16

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

View all 16

Care Compare: Hospital

Medicare Care Compare
Listed as
Alton Mental Health CenterCCN 144016 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Howe Center - Unit 4267292 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Victoria Pyles Individual Corporate OfficerPsa Jul 1, 2016
John Baumgartner Individual W-2 Managing EmployeeReimbursement Officer Nov 2, 2015
Mark a Bartolozzi Individual Corporate Director Jul 16, 2016
W-2 Managing Employee Jul 16, 2016
Illinois Department of Human Services Organization, Springfield, IL 5% Or Greater Direct Ownership Interest Dec 1, 1996 100%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Elgin Mental Health CenterElgin, IL, CCN 144037 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1975
Chicago Read Mental Health CenterChicago, IL, CCN 144010 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1970
Elizabeth Parsons Ware Packard Mental Health CenterSpringfield, IL, CCN 144021 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1975
John J Madden Mental Health CenterHines, IL, CCN 144028 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1975

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1083620827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "62002",
            "telephone_number": "618-474-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "PIEPHOFF",
        "authorized_official_first_name": "TONYA",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "618-474-3473"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000194572001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alton Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alton Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.