NPIMap

Organization Active NPI

Clay County Health Department

Doing business as Clay Home Health Services

  • Home Health Agency
  • Flora, IL
National Provider Identifier
1083799035
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1000157 Issued in IL
Legal business name
CLAY COUNTY HEALTH DEPARTMENT
Doing business as
Clay Home Health Services
Practice address
601 E 12TH St
Flora, IL 62839-2335
Phone
(618) 662-4406
Fax
(618) 662-2801
NPI assigned
Oct 26, 2006
Last updated
Mar 24, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CLAY COUNTY HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Authorized official

Name
Mr. Jeff Alan Workman
Title
Administrator
Phone
(618) 662-4406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1000157 IL Primary

Addresses

Primary practice location

601 E 12TH St
Flora, IL 62839-2335

Mailing address

601 E 12TH St
Flora, IL 62839-2335
Phone (618) 662-4406

Other identifiers 1

IdentifierTypeStateIssuer
50257OtherILBLUE CROSS/BLUESHIELD

Other names 1

  • Clay Home Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100504000176 IL Part A Provider - Home Health Agency 4082524301 Practice locations: Flora, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083799035. Details of each certification follow.

Home health agency certification: CCN 147086

Legal name
CLAY COUNTY HEALTH DEPARTMENT
Doing business as
CLAY HOME HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 18, 1967
Last certification
Sep 23, 2020
Ownership / control type
Government Operated
Organization structure
GovernmentNon-profit
Enrollment address
601 East 12TH Street
Flora, IL 62839-2335

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Clay Home Health ServicesCCN 147086 · All quality measures
Overall star rating
2.5 of 5
Ownership
Government Operated
Certified
Dec 18, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Clay County Health Dept3 organizations share this tax ID, including this one
Part of
Clay County Health Dept

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Lisa Cash Individual Operational/Managerial Control Jul 1, 2019
Barb McGrew Individual Operational/Managerial Control Dec 1, 2022
Joe McCoy Individual Operational/Managerial Control Aug 8, 2023
Christine Boyd Individual Operational/Managerial Control Aug 8, 2023
Scott Christopher Suntrup Individual Operational/Managerial Control Feb 2, 2022
Joel L Hackney Individual Operational/Managerial Control Dec 1, 2014
Jeffery Workman Individual Corporate Director Sep 19, 1991
W-2 Managing Employee Sep 19, 1991
Operational/Managerial Control Sep 19, 1991
Clay County Health Department Organization, Flora, IL Non-profit 5% Or Greater Direct Ownership Interest Dec 29, 1966
Operational/Managerial Control Dec 18, 1967
Jon R Wells Individual Operational/Managerial Control Nov 30, 2007
Larry C Rinehart Individual Operational/Managerial Control Dec 1, 2014
Michael P Klingler Individual Operational/Managerial Control Nov 30, 2008
Brandon L Cycholl Individual Operational/Managerial Control Dec 1, 2015
Cathy Croy Individual Operational/Managerial Control Feb 2, 2022

Owners & managing parties with NPI records 5

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
Clay County Health Department HospiceFlora, IL, CCN 141611 Hospice 5% Or Greater Direct Ownership Interest (100%) Feb 11, 2003

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 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1083799035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E 12TH ST",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628392335",
            "telephone_number": "618-662-4406",
            "fax_number": "618-662-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 12TH ST",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628392335",
            "telephone_number": "618-662-4406",
            "fax_number": "618-662-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLAY COUNTY HEALTH DEPARTMENT",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-662-4406",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1000157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUESHIELD",
            "identifier": "50257",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flora, IL

Sources for this page

Verify at the official NPI Registry.