NPIMap

Organization Active NPI

Ferrell Hospital Community Foundation

  • Critical Access Hospital
  • Eldorado, IL
National Provider Identifier
1336137686
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 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
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary
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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336137686. Details of each certification follow.

Skilled nursing facility certification: CCN 14Z324

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

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Ferrell HSP Comm Foundation10 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 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 DirectorBoard 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 EmployeeChief Nursing Officer Mar 26, 2018 5%
Ayn Bartok Individual Corporate Director Apr 1, 2018
E. T. Seely Individual Corporate DirectorBoard Member Sep 23, 2009
Jeffrey R Campbell Individual Corporate DirectorDirector Jan 1, 2019
Barb Devous Individual Corporate DirectorBoard Member Oct 17, 2013
Austin Rahmoeller Individual Corporate Director Jun 1, 2019
Clifford E Morris Individual Corporate DirectorBoard 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 DirectorBoard Member Jul 1, 2013
Alisa Coleman Individual Operational/Managerial ControlCeo 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 EmployeePFS Director Jan 28, 2014
Shawn W McCoy Individual Corporate DirectorBoard 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 DirectorBoard Member Feb 25, 2016 10%

Owners & managing parties with NPI records 9

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

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 ClinicEldorado, IL, CCN 148507 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2005

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 35

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

View all 35

Practitioners & affiliated clinicians

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": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1336137686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PINE STREET",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "62930",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PINE STREET",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "62930",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRELL HOSPITAL COMMUNITY FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "618-273-3361"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldorado, IL

Sources for this page

Verify at the official NPI Registry.