NPIMap

Organization Active NPI

Deaconess Illinois Crossroads Inc

  • General Acute Care Hospital
  • Mount Vernon, IL
National Provider Identifier
1124745807
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DEACONESS ILLINOIS CROSSROADS INC
Practice address
8 Doctors Park Rd
Mount Vernon, IL 62864-6224
Phone
(618) 244-5500
Fax
(618) 244-5566
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Authorized official

Name
Jason Andrew Hinkle
Title
Cfo
Phone
(618) 998-7020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

8 Doctors Park Rd
Mount Vernon, IL 62864-6224

Mailing address

PO Box 631956
Cincinnati, OH 45263-1956
Phone (812) 450-6815

Other practice location 1

4 Doctors Park Rd
Mount Vernon, IL 62864-6223
Phone (618) 244-5500

Other names 2

  • Crossroads Community Hospital Doing business as
  • Deaconess Illinois Crossroads Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230301002192 IL Part A Provider - Hospital 0143692178 Practice locations: Mount Vernon, IL

Hospital certification: CCN 140294

Legal name
DEACONESS ILLINOIS CROSSROADS INC
Doing business as
DEACONESS ILLINOIS CROSSROADS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Sep 23, 1982
Last certification
May 2, 2019
Beds
56
Ownership / control type
Private (for profit)
Most recent change of ownership
Jan 14, 2023 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 3, 2022 in IL
Enrollment address
8 Doctors Park Rd
Mount Vernon, IL 62864-6224
Main/Primary Hospital Location
Hospital subgroups
Acute care, Rehabilitation unit

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

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: Hospital

Medicare Care Compare
Listed as
Deaconess Illinois CrossroadsCCN 140294
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
14D0875987Deaconess Illinois Crossroads#8 Doctors Park, Mount Vernon, IL 62864AccreditationJun 12, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Anthony Wielt Individual Corporate OfficerTreasurer Aug 1, 2023 100%
Corporate DirectorBoard Member Aug 1, 2023 20%
Marc J Florence Individual Corporate DirectorBoard Member Oct 3, 2022 20%
Clifford E Morris Individual Corporate OfficerSecretary Aug 1, 2023 100%
Corporate DirectorBoard Member Dec 12, 2022 20%
William Davis Individual Corporate OfficerPresident Dec 1, 2023 100%
Deaconess Health System Inc Organization, Evansville, IN Corporation, Non-profit Other Jan 14, 2023 100%
Amber R Lipe Individual Contracted Managing EmployeeCfo Aug 1, 2023 100%
Corporate OfficerCfo Aug 1, 2023 100%
Operational/Managerial ControlCfo Aug 1, 2023 100%
Lynn C Lingafelter Individual Corporate DirectorBoard Member Jul 31, 2023 20%
Jeffrey a Justice Individual Corporate DirectorBoard Member Dec 12, 2022 20%
Stephen T Titzer Individual Corporate OfficerChair Aug 1, 2023 100%
Corporate DirectorBoard Member Dec 12, 2022 20%
Shawn W McCoy Individual OtherCeo - Chain Home Office Admin Jan 14, 2023 100%
Harold G Clarida Individual Corporate OfficerVice Chair Aug 1, 2023 100%
Corporate DirectorBoard Member Dec 12, 2022 20%
Deaconess Regional Healthcare Services Illinois Inc Organization, Chicago, IL Corporation, Medical provider/supplier, Non-profit 5% Or Greater Direct Ownership Interest Oct 3, 2022 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 158

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

View all 158

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1124745807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631956",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631956",
            "telephone_number": "812-450-6815",
            "fax_number": "812-450-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 DOCTORS PARK RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646224",
            "telephone_number": "618-244-5500",
            "fax_number": "618-244-5566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Doctors Park Rd",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628646223",
            "country_code": "US",
            "telephone_number": "618-244-5500",
            "fax_number": "618-244-5566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DEACONESS ILLINOIS CROSSROADS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "HINKLE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "618-998-7020"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Crossroads Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deaconess Illinois Crossroads",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.