NPIMap

Organization Active NPI

Salem Township Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Salem, IL
National Provider Identifier
1184783425
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
0002089 Issued in IL
Legal business name
SALEM TOWNSHIP HOSPITAL
Practice address
1201 Ricker Drive
Salem, IL 62881
Phone
(618) 548-3194
Fax
(618) 548-2137
NPI assigned
Dec 6, 2006
Last updated
Aug 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Mr. James Timpe
Title
President/Ceo/Cfo
Phone
(618) 548-3194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 0002089 IL Primary

Addresses

Primary practice location

1201 Ricker Drive
Salem, IL 62881

Mailing address

1201 Ricker Drive
Salem, IL 62881
Phone (618) 548-3194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071227000325 IL Part A Provider - Critical Access Hospital 0840195277 Practice locations: Salem, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184783425. Details of each certification follow.

Hospital certification: CCN 14Z345

Legal name
SALEM TOWNSHIP HOSPITAL
Organization structure
GovernmentProprietary
Incorporated
May 1, 1942 in IL
Enrollment address
1201 Ricker Rd
Salem, IL 62881-4263

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Public Hosp of the Town6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13311/brand/1/csg/1/fhir/r4
  • FHIR API: https://ssproxy.osfhealthcare.org/fhir-proxy/api/FHIR/R4

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Salem Township Hospital Organization, Salem, IL 5% Or Greater Direct Ownership Interest May 1, 2005 100%
Michael L Morton Individual Corporate DirectorChairman of Governing Board Feb 1, 2010
Todd Woodruff Individual Corporate DirectorBoard Member Aug 1, 2015
Mark Clark Individual Corporate DirectorBoard Member May 1, 2018
Sandra Phillips Individual Corporate DirectorBoard Member Jan 1, 2013
Amy Marsh Individual Corporate OfficerChief Financial Officer Dec 5, 2023
W-2 Managing Employee Dec 5, 2023

Owners & managing parties with NPI records 3

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
Salem Township HospitalSalem, IL, CCN 141345 Hospital 5% Or Greater Direct Ownership Interest (100%) May 1, 2005
Salem Township Hospital Rural Health ClinicSalem, IL, CCN 143413 Rural health clinic Operational/Managerial Control Jul 1, 2018
STH Family Health Care CenterSalem, IL, CCN 148608 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

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 2

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1184783425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 RICKER DRIVE",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "62881",
            "telephone_number": "618-548-3194",
            "fax_number": "618-548-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RICKER DRIVE",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "62881",
            "telephone_number": "618-548-3194",
            "fax_number": "618-548-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEM TOWNSHIP HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "TIMPE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT/CEO/CFO",
        "authorized_official_telephone_number": "618-548-3194",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IL",
            "license": "0002089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

Verify at the official NPI Registry.