NPIMap

Organization Active NPI

Carlinville Area Hospital Association

Doing business as Carlinville Area Hospital Association - Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Carlinville, IL
National Provider Identifier
1275609109
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
0000182 Issued in IL
Legal business name
CARLINVILLE AREA HOSPITAL ASSOCIATION
Doing business as
Carlinville Area Hospital Association - Swing Bed
Practice address
20733 North Broad Street
Carlinville, IL 62626
Phone
(207) 854-3141
Fax
(217) 854-3744
NPI assigned
Nov 24, 2006
Last updated
Jun 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Brian D. Burnside
Title
Ceo
Phone
(217) 854-3141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 0000182 IL Primary

Addresses

Primary practice location

20733 North Broad Street
Carlinville, IL 62626

Mailing address

20733 North Broad Street
Carlinville, IL 62626
Phone (217) 854-3141

Other names 1

  • Carlinville Area Hospital Association - Swing Bed Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000690 IL Part A Provider - Critical Access Hospital 9032021373 Practice locations: Carlinville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275609109. Details of each certification follow.

Hospital certification: CCN 14Z347

Legal name
CARLINVILLE AREA HOSPITAL ASSOCIATION
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 1952 in IL
Enrollment address
20733 N Broad St
Carlinville, IL 62626-3710
Main/Primary Hospital Location

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Carlinville Area Hospti10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Jay Hodges Individual Corporate OfficerCfo Nov 1, 2024
Richard Walden Individual Corporate Director Jul 1, 2005
Jim Salske Individual Corporate DirectorBoard Member Jul 1, 2001
Brian D Burnside Individual Corporate OfficerPresident/Ceo Aug 1, 2020
W-2 Managing EmployeeCeo Aug 1, 2020
Katie M Goodman-Thomas Individual Corporate DirectorBoard Member Jan 1, 2022
Heather Anne Deneve Individual Corporate DirectorBoard Treasurer Jan 1, 2018
Middle Macoupin Healthcare Systems, Inc. Organization, Carlinville, IL Corporation, Non-profit Operational/Managerial Control Jul 1, 2005 100%
Tom Denby Individual Corporate DirectorBoard Member Jan 1, 2022
Dennis Pickrel Individual Corporate DirectorBoard Chairman Jan 1, 2013
Kristin Boldt Individual Corporate DirectorAssistant Cfo and Revenue Cycle Dir Feb 11, 2025

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Carlinville Family Health CareCarlinville, IL, CCN 148530 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 18, 2013
Nov 26, 2002
Virden Family Health CareVirden, IL, CCN 148532 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2013

Owned or controlled facilities with NPI records 2

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 26

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 26

Affiliated clinicians 6

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1275609109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20733 NORTH BROAD STREET",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "217-854-3141",
            "fax_number": "217-854-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20733 NORTH BROAD STREET",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "62626",
            "telephone_number": "207-854-3141",
            "fax_number": "217-854-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLINVILLE AREA HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "BURNSIDE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-854-3141"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IL",
            "license": "0000182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlinville Area Hospital Association - Swing Bed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlinville, IL

Sources for this page

Verify at the official NPI Registry.