NPIMap

Ferrell Hospital Community Foundation

Organization Active NPI Critical Access Hospital · Eldorado, IL

NPI 1336137686 · NPPES record last updated Feb 12, 2024

Key facts

NPI
1336137686
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
Legal business name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Practice address
1201 Pine Street
Eldorado, IL 62930
Phone
(618) 273-3361
Fax
(618) 273-5501
NPI assigned
Oct 11, 2005
Organization subpart
No

Authorized official

Name
Clifford E Morris
Title
Authorized Official
Phone
(618) 273-3361

Owners & managing parties with NPI records 9

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

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 9

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

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

Facilities with the same owner 35

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 35

Practitioners 58

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

View all 58

Affiliated clinicians 6

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Skilled nursing facility certification: CCN 14Z324

Legal name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
FERRELL HOSPITAL
Organization structure
Other · Non-profit
Incorporated
Mar 31, 2004 in IL
Enrollment address
1201 Pine St
Eldorado, IL 62930-1634

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jason Kasiar
Individual 		Corporate Director
Board Member		 Jul 1, 2013
Ferrell Hospital Community Foundation
Organization · Eldorado, IL
Non-profit 		5% Or Greater Direct Ownership Interest Apr 1, 2005 100%
Rachael Prather
Individual 		W-2 Managing Employee
Chief Nursing Officer		 Mar 26, 2018 5%
Ayn Bartok
Individual 		Corporate Director Apr 1, 2018
E. T. Seely
Individual 		Corporate Director
Board Member		 Sep 23, 2009
Jeffrey R Campbell
Individual 		Corporate Director
Director		 Jan 1, 2019
Barb Devous
Individual 		Corporate Director
Board Member		 Oct 17, 2013
Austin Rahmoeller
Individual 		Corporate Director Jun 1, 2019
Clifford E Morris
Individual 		Corporate Director
Board Member		 Jan 28, 2014
Deaconess Health System Inc
Organization · Evansville, IN
Corporation, Non-profit 		Operational/Managerial Control Feb 25, 2016 20%
Nathan Oldham
Individual 		Corporate Director
Board Member		 Jul 1, 2013
Alisa Coleman
Individual 		Operational/Managerial Control
Ceo		 Jul 1, 2015 25.03%
Deaconess Regional Healthcare Network Illinois LLC
Organization · Evansville, IN
LLC 		Operational/Managerial Control Feb 25, 2016 20%
Jodie a Smith
Individual 		W-2 Managing Employee
PFS Director		 Jan 28, 2014
Shawn W McCoy
Individual 		Corporate Director
Board Member		 Feb 25, 2016 10%
Deaconess Regional Healthcare Services Illinois Inc
Organization · Evansville, IN
Corporation, Non-profit 		Operational/Managerial Control Feb 25, 2016 100%
James Porter
Individual 		Corporate Director
Board Member		 Feb 25, 2016 10%

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Eldorado Family Medicine Clinic
Eldorado, IL · CCN 148507		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2005

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130621000104 IL Part a Provider - Skilled Nursing Facility 1355389453 Practice locations: Eldorado, IL

National Provider Directory

Tax ID family
Ferrell HSP Comm Foundation (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Yes
Critical Access Hospital 282NC0060X IL

Addresses

Primary practice location

1201 Pine Street
Eldorado, IL 62930

Mailing address

1201 Pine Street
Eldorado, IL 62930
Phone (618) 273-3361

Other providers in Eldorado, IL

All providers in Eldorado, IL · Critical Access Hospital in Illinois

Sources for this page

Verify at the official NPI Registry.