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Cass County Public Health Dept

Organization Active NPI Federally Qualified Health Center (FQHC) · Virginia, IL

NPI 1164596375 · NPPES record last updated Oct 8, 2025

Key facts

NPI
1164596375
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CASS COUNTY PUBLIC HEALTH DEPT
Practice address
331 S Main St
Virginia, IL 62691-1519
Phone
(217) 452-3057
Fax
(217) 452-7245
NPI assigned
Nov 20, 2006
Organization subpart
No

Authorized official

Name
Ms. Tiffany Angelo, RN, BSN
Title
Administrator
Phone
(217) 452-3057

Owners & managing parties with NPI records 4

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

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 4

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

Member of 1

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

Facilities with the same owner 3

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

Practitioners 11

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL

Federally qualified health center certification: CCN 141047

Legal name
CASS COUNTY PUBLIC HEALTH DEPT
Doing business as
CASS COUNTY HEALTH CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 21, 2007
Last certification
Nov 21, 2007
Ownership / control type
Non-profit – corporation
Organization structure
Government · Non-profit
Enrollment address
331S Main St
Virginia, IL 62691-1571

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Cass County Public Health Dept
Organization · Virginia, IL 		Operational/Managerial Control Dec 1, 2007 100%
Tiffany Angelo
Individual 		W-2 Managing Employee
Ad;		 Oct 1, 2025 100%

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cass County Home Health Agency
Virginia, IL · CCN 147221		 Home health agency Operational/Managerial Control Jul 23, 1983
Cass County Public Health Dept
Virginia, IL · CCN 141571		 Hospice Operational/Managerial Control (100%) Aug 4, 1994
Cass County Health Clinic
Beardstown, IL · CCN 781826		 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070202000246 IL Part B Supplier - Clinic/Group Practice 5395745137 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Beardstown, IL; Virginia, IL
O20071008000112 IL Part a Provider - Federally Qualified Health Center (FQHC) 5395745137 Practice locations: Virginia, IL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

331 S Main St
Virginia, IL 62691-1519

Mailing address

331 S Main St
Virginia, IL 62691-1571
Phone (217) 452-3057

Other names

  • Cass County Health Clinic Doing business as

Other providers in Virginia, IL

All providers in Virginia, IL · Federally Qualified Health Center (FQHC) in Illinois

Sources for this page

Verify at the official NPI Registry.