Hammond Henry Dist Hospital
Organization Active NPI Rural Health Clinic/Center · Annawan, IL
NPI 1114582913 · NPPES record last updated Feb 18, 2026
Key facts
- NPI
- 1114582913
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- HAMMOND HENRY DIST HOSPITAL
- Practice address
- 203 W Front St
Annawan, IL 61234-7756 - Phone
- (309) 935-4100
- Fax
- (309) 520-2565
- NPI assigned
- May 7, 2019
- Organization subpart
- No
Authorized official
- Name
- Rhonda Rice
- Title
- Revenue Cycle Manager
- Phone
- (309) 944-9122
Owners & managing parties with NPI records 6
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 6
Corporate family (same tax ID) 12
Related certifications (CCN) 1
Facilities with the same owner 4
Practitioners 42
-
Lori Anderson, DNP, APN, FNP-BC, AT
-
Allison Jo David, DC, ATC
-
Angela Schmieder, PA-C
-
Ryan M Pizinger, MD
-
Carlos Miguel Avila, M.D.
-
Emily Rose Bess, MSN, APRN, FNP-C
-
Jennifer Brokaw, F.N.P.
-
Staci Lynne Circello, APRN
-
Jill Clong, NP-C
-
Kati Grimes, FNP-C
-
Michelle Lynn Jackson, APRN
-
Kevin M. Jeffries, M.D.
-
Manoj Kohli, MD
-
Heather Renee Lowry, NP-C
-
Owen James McConnell, DC, ATC, LAT
-
Cassandra Olson, ARNP
-
Sandra L. Peach, APN
-
Janelle Pillard, PA-C
-
David W Prygon, CNRA
-
Hamid Sagha, MD
-
Remigijus Satkauskas, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2141558 | Hammond-Henry Hospital Annawan Clinic | Certificate of waiver | Dec 14, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL
Rural health clinic certification: CCN 148615
- Legal name
- HAMMOND HENRY DIST HOSPITAL
- Doing business as
- HAMMOND HENRY ANNAWAN CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 25, 2020
- Last certification
- Aug 25, 2020
- Ownership / control type
- 2B
- Organization structure
- Government · Non-profit
- Enrollment address
- 203 W Front St
Annawan, IL 61234-7756 - Related CCNs
- 141319
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Hammond Henry Dist Hospital |
5% Or Greater Direct Ownership Interest | Dec 1, 2019 | 100% |
| Heather D Charlet |
W-2 Managing Employee |
Jul 3, 2022 | |
| Kimberly Gehling |
Corporate Officer |
Jun 1, 2025 | |
| Douglas Ford |
Corporate Officer |
Jun 1, 2025 | |
| Nancy Lang |
Corporate Officer |
Jun 1, 2025 | |
| Wyatt Brieser |
Corporate Officer |
Aug 26, 2025 | |
| W-2 Managing Employee |
Aug 26, 2025 | ||
| Jodie Criswell |
Corporate Officer |
May 19, 2011 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Hammond Henry Dist Hospital |
Hospital | Operational/Managerial Control | Jun 4, 2002 |
| Home Health of Hammond Henry Hospital |
Home health agency | Operational/Managerial Control | Aug 22, 2025 |
| Hammond Henry Dist Hospital |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 31, 2017 |
| Hammond Henry Dist Hospital |
Rural health clinic | 5% Or Greater Direct Ownership Interest | May 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170511000385 | IL | Part B Supplier - Clinic/Group Practice | 0143115949 |
Receives reassigned benefits from 36 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Annawan, IL; Cambridge, IL; Geneseo, IL; Kewanee, IL; Orion, IL; Wyoming, IL |
| O20190919000007 | IL | Part a Provider - Rural Health Clinic | 0143115949 | Practice locations: Annawan, IL |
National Provider Directory
- Tax ID family
- Hammond Henry Dist Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
203 W Front St
Annawan, IL 61234-7756
Mailing address
600 N College Ave
Geneseo, IL 61254-1091
Phone (309) 944-6431
Other names
- Hammond Henry Annawan Clinic
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mailbox@xdrhammondhenry.com | Direct |
Other providers in Annawan, IL
- Lori Anderson
- Annawan Community Unit 226
- Annawan-Alba Fire Protection District
- Countrywide Smiles P.C.
- Kelli Rae Desplinter
- Iowa Physicians Clinic Medical Foundation
- Jeffrey Lynn Lathrop
- Rima Mounsef
- Randall L Mullin
- Janelle Pillard
All providers in Annawan, 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 18, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.