Active NPI
Franklin Williamson Bicounty Health Dept
- Home Health Agency
- Marion, IL
National Provider Identifier
1326041294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1001437
- Legal business name
- FRANKLIN WILLIAMSON BICOUNTY HEALTH DEPT
- Practice address
- 8160 Express Dr
Marion, IL 62959 - Phone
- (618) 993-8111
- Fax
- (618) 993-6455
- NPI assigned
- May 24, 2005
- Last updated
- Jun 23, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tony McEntire, M.S.
- Title
- Administrator
- Phone
- (618) 993-8111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1001437 | IL | Primary |
Addresses
Primary practice location
8160 Express Dr
Marion, IL 62959
Mailing address
8160 Express Dr
Marion, IL 62959
Phone (618) 993-8111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051202000089 | IL | Part A Provider - Home Health Agency | 0941220107 | Practice locations: Marion, IL |
| O20061229000063 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 0941220107 |
1 other NPI on this enrollment Practice locations: Benton, IL; Marion, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1326041294. Details of each certification follow.
Home health agency certification: CCN 147027
- Legal name
- FRANKLIN WILLIAMSON BICOUNTY HEALTH DEPT
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 1, 1966
- Last certification
- Jan 29, 2020
- Ownership / control type
- Government Operated
- Organization structure
- Government
- Enrollment address
- 8160 Express Dr
Marion, IL 62959-5817
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Public Health or Welfare Agency
- Marion, IL
- NPI 1770995490
O20061229000063
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Franklin Williamson Bi County
- Overall star rating
- Ownership
- Government Operated
- Certified
- Jul 1, 1966
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology
National Provider Directory
National Provider Directory- Tax ID family
- Franklin Williamson Dept
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Marion, IL
- NPI 1770995490
Locations
403 E Park St
Benton, IL 62812
Phone (618) 439-0951
8160 Express Dr
Marion, IL 62959
Phone (618) 993-8111
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Franklin Williamson Bicounty Health Dept | 5% Or Greater Direct Ownership Interest | Nov 16, 2011 | 100% |
| Kevin Kaytor | W-2 Managing Employee | Aug 7, 2017 | 100% |
| Operational/Managerial Control | Aug 7, 2017 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 18
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Christopher, IL
- NPI 1942287321
Home health agency
-
- Family Medicine Physician
- Carterville, IL
- NPI 1326429242
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1466640000000",
"number": "1326041294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8160 EXPRESS DR",
"city": "MARION",
"state": "IL",
"postal_code": "62959",
"telephone_number": "618-993-8111",
"fax_number": "618-993-6455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8160 EXPRESS DR",
"city": "MARION",
"state": "IL",
"postal_code": "62959",
"telephone_number": "618-993-8111",
"fax_number": "618-993-6455"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRANKLIN WILLIAMSON BICOUNTY HEALTH DEPT",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-24",
"last_updated": "2016-06-23",
"status": "A",
"authorized_official_last_name": "MCENTIRE",
"authorized_official_first_name": "TONY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "618-993-8111",
"authorized_official_credential": "M.S."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "1001437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.