NPIMap

Organization Active NPI

Ferrell Hospital Community Foundation

Doing business as Harrisburg Small Street Clinic

  • Multi-Specialty Clinic/Center
  • Harrisburg, IL
National Provider Identifier
1124905351
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
Harrisburg Small Street Clinic
Practice address
Harrisburg Small Street Clinic
250 Small Street
Harrisburg, IL 62946-3319
Phone
(618) 294-8264
Fax
(618) 294-8265
NPI assigned
Aug 19, 2025
Last updated
Oct 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FERRELL HOSPITAL COMMUNITY FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Clifford E Morris
Title
Director of Board
Phone
(618) 273-3361

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Family Medicine Physician 207Q00000X NU
Cardiovascular Disease Physician 207RC0000X NU
Gastroenterology Physician 207RG0100X NU
Interventional Cardiology Physician 207RI0011X NU
Pulmonary Disease Physician 207RP1001X NU
Rheumatology Physician 207RR0500X NU
Surgery Physician 208600000X NU
Colon & Rectal Surgery Physician 208C00000X NU
Podiatrist 213E00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Women's Health Nurse Practitioner 363LW0102X NU

Addresses

Primary practice location

Harrisburg Small Street Clinic
250 Small Street
Harrisburg, IL 62946-3319

Mailing address

1201 Pine St
Eldorado, IL 62930-1634
Phone (618) 273-3361

Other names 1

  • Harrisburg Small Street Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090630000256 IL Part B Supplier - Clinic/Group Practice 1355389453 Receives reassigned benefits from 74 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Harrisburg, IL; MC Leansboro, IL; Eldorado, IL; Carmi, IL

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Ferrell Hospital Pharmacy10 organizations share this tax ID, including this one
Part of
Ferrell Hospital Pharmacy

Other organizations with this tax ID 9

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

Locations

1338 IL Highway 1
Ste B
Carmi, IL 62821
Phone 61827333611660

1407 Locust St
Eldorado, IL 62930
Phone (618) 273-3361

201 E Main St
Galatia, IL 62935
Phone (618) 268-6165

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1124905351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PINE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301634",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HARRISBURG SMALL STREET CLINIC",
            "address_2": "250 SMALL STREET",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629463319",
            "telephone_number": "618-294-8264",
            "fax_number": "618-294-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRELL HOSPITAL COMMUNITY FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FERRELL HOSPITAL COMMUNITY FOUNDATION",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR OF BOARD",
        "authorized_official_telephone_number": "618-273-3361"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harrisburg Small Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.