NPIMap

Organization Active NPI

Cass County Public Health Dept

Doing business as Cass County Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Virginia, IL
National Provider Identifier
1164596375
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CASS COUNTY PUBLIC HEALTH DEPT
Doing business as
Cass County Health Clinic
Practice address
331 S Main St
Virginia, IL 62691-1519
Phone
(217) 452-3057
Fax
(217) 452-7245
NPI assigned
Nov 20, 2006
Last updated
Oct 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • Cass County Health Clinic Doing business as

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164596375. Details of each certification follow.

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
GovernmentNon-profit
Enrollment address
331S Main St
Virginia, IL 62691-1571

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

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 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 EmployeeAd; Oct 1, 2025 100%

Owners & managing parties with NPI records 4

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

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 AgencyVirginia, IL, CCN 147221 Home health agency Operational/Managerial Control Jul 23, 1983
Cass County Public Health DeptVirginia, IL, CCN 141571 Hospice Operational/Managerial Control (100%) Aug 4, 1994
Cass County Health ClinicBeardstown, IL, CCN 781826 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2014

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 11

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1164596375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 S MAIN ST",
            "city": "VIRGINIA",
            "state": "IL",
            "postal_code": "626911571",
            "telephone_number": "217-452-3057",
            "fax_number": "217-452-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 S MAIN ST",
            "city": "VIRGINIA",
            "state": "IL",
            "postal_code": "626911519",
            "telephone_number": "217-452-3057",
            "fax_number": "217-452-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASS COUNTY PUBLIC HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "ANGELO",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "217-452-3057",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cass County Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia, IL

Sources for this page

Verify at the official NPI Registry.