NPIMap

Organization Active NPI

County of Henry

  • Rural Health Clinic/Center
  • Toulon, IL
National Provider Identifier
1245049501
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COUNTY OF HENRY
Practice address
120 E Court St
Toulon, IL 61483-5388
Phone
(309) 852-3115
NPI assigned
Jan 2, 2025
Organization subpart
Yes
Parent organization
COUNTY OF HENRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Authorized official

Name
Tara Lafollette
Title
Credentialing Specialist
Phone
(309) 852-0197

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

120 E Court St
Toulon, IL 61483-5388

Mailing address

110 N Burr Blvd
Kewanee, IL 61443-2214
Phone (309) 852-5272

Other names 1

  • First Choice Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250212002739 IL Part A Provider - Rural Health Clinic 5193828556 Practice locations: Toulon, IL

Rural health clinic certification: CCN 783867

Legal name
COUNTY OF HENRY
Doing business as
FIRST CHOICE HEALTHCARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 24, 2025
Last certification
Jun 24, 2025
Ownership / control type
Non-profit – church related
Organization structure
GovernmentProprietary
Enrollment address
120 E Court St
Toulon, IL 61483-5388

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
County of Henry3 organizations share this tax ID, including this one
Part of
County of Henry

Other organizations with this tax ID 2

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

103 1st St
Colona, IL 61241
Phone (309) 792-4011

110 N Burr Blvd
Kewanee, IL 61443
Phone (309) 852-0197

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
Kelli Humphrey Individual W-2 Managing EmployeeDirector of Financial Services Jan 1, 2025
Duane Stevens Individual Other Jan 1, 2025

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hillcrest HomeGeneseo, IL, CCN 145949 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 28, 2011
Sep 28, 2011
Sep 28, 2011
Sep 28, 2011

Owned or controlled facilities with NPI records 1

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

  • Hillcrest Home
    • Skilled Nursing Facility
    • Geneseo, IL
    • NPI 1770582330

    5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1245049501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N BURR BLVD",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614432214",
            "telephone_number": "309-852-5272",
            "fax_number": "309-854-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E COURT ST",
            "city": "TOULON",
            "state": "IL",
            "postal_code": "614835388",
            "telephone_number": "309-852-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF HENRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF HENRY",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "LAFOLLETTE",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "309-852-0197"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toulon, IL

Sources for this page

Verify at the official NPI Registry.