NPIMap

Organization Active NPI

Hammond Henry Dist Hospital

Doing business as Hammond Henry Annawan Clinic

  • Rural Health Clinic/Center
  • Annawan, IL
National Provider Identifier
1114582913
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HAMMOND HENRY DIST HOSPITAL
Doing business as
Hammond Henry Annawan Clinic
Practice address
203 W Front St
Annawan, IL 61234-7756
Phone
(309) 935-4100
Fax
(309) 520-2565
NPI assigned
May 7, 2019
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Rhonda Rice
Title
Revenue Cycle Manager
Phone
(309) 944-9122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

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 1

  • Hammond Henry Annawan Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mailbox@xdrhammondhenry.com Direct

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114582913. Details of each certification follow.

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
GovernmentNon-profit
Enrollment address
203 W Front St
Annawan, IL 61234-7756
Related CCNs
141319

Facilities connected through Provider of Services related, parent or unit certification numbers.

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 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2141558Hammond-Henry Hospital Annawan Clinic203 W Front St, Annawan, IL 61234Certificate of waiverDec 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hammond Henry Dist Hosp13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Interoperability endpoints

  • Direct secure messaging: mailbox@xdrhammondhenry.com

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Hammond Henry Dist Hospital Organization, Geneseo, IL 5% Or Greater Direct Ownership Interest Dec 1, 2019 100%
Heather D Charlet Individual W-2 Managing EmployeeChief Nursing Officer Jul 3, 2022
Kimberly Gehling Individual Corporate OfficerVice Chair Jun 1, 2025
Douglas Ford Individual Corporate OfficerChair Jun 1, 2025
Nancy Lang Individual Corporate OfficerTreasurer Jun 1, 2025
Wyatt Brieser Individual Corporate OfficerCeo Aug 26, 2025
W-2 Managing EmployeeCeo Aug 26, 2025
Jodie Criswell Individual Corporate OfficerVP of Fiscal Services May 19, 2011

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
Hammond Henry Dist HospitalGeneseo, IL, CCN 14Z319 Hospital Operational/Managerial Control Jun 4, 2002
Home Health of Hammond Henry HospitalGeneseo, IL, CCN 147450 Home health agency Operational/Managerial Control Aug 22, 2025
Hammond Henry Dist HospitalKewanee, IL, CCN 148576 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 31, 2017
Hammond Henry Dist HospitalGeneseo, IL, CCN 148587 Rural health clinic 5% Or Greater Direct Ownership Interest May 1, 2018

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 6

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": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1114582913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N COLLEGE AVE",
            "city": "GENESEO",
            "state": "IL",
            "postal_code": "612541091",
            "telephone_number": "309-944-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W FRONT ST",
            "city": "ANNAWAN",
            "state": "IL",
            "postal_code": "612347756",
            "telephone_number": "309-935-4100",
            "fax_number": "309-520-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMMOND HENRY DIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-07",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "309-944-9122"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mailbox@xdrhammondhenry.com",
            "affiliation": "N",
            "endpointDescription": "use this for all providers",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "203 W Front St",
            "city": "Annawan",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612347756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hammond Henry Annawan Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hammond Henry Annawan Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annawan, IL

Sources for this page

Verify at the official NPI Registry.