Kenneth Hall Regional Hospital

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

0002667 Issued in IL

Legal business name

KENNETH HALL REGIONAL HOSPITAL

Practice address

129 N 8TH St
East Saint Louis, IL 62201-2917

Phone

(618) 274-1900

Fax

(618) 482-7009

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Michael McManus

Title

Chief Operating Officer

Phone

(618) 274-1900

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 140066

Legal name

KENNETH HALL REGIONAL HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Jul 1, 2009

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Nov 8, 1996

Beds

169

Ownership / control type

Church

Facility address

129 N 8TH St
East Saint Louis, IL 62201

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306907910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 N 8TH ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622012917",
            "telephone_number": "618-274-1900",
            "fax_number": "618-482-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N 8TH ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622012917",
            "telephone_number": "618-274-1900",
            "fax_number": "618-482-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH HALL REGIONAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCMANUS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "618-274-1900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0002667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ILLINOIS",
            "identifier": "0143",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH PLAN",
            "identifier": "31264",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "115992",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY HEALTH PLAN",
            "identifier": "240713",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sreekanth Kanagarla, D.D.S.
• Kirsten Karkow, DDS, MS
• Marshall Katzman, M.D.
• Sarah A Kehl, MSW/LCSW
• Timothy J Kelly, MA, LCPC
• Kenneth Hall Regional Hospital, Inc.
• Destiny D. Kharsi, LCSW
• Maryana F Kirolos, D.D.S.
• Denise J Krone, FNP,BC
• Jean Lammers, PT

• General Acute Care Hospital in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• General Acute Care Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.