NPIMap

Organization Active NPI

City of Clinton

Doing business as Warner Hospital and Health Services

  • Rural Health Clinic/Center
  • Clinton, IL
National Provider Identifier
1366504565
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
0001164 Issued in IL
Legal business name
CITY OF CLINTON
Doing business as
Warner Hospital and Health Services
Practice address
422 W White St
Clinton, IL 61727-2272
Phone
(217) 935-9571
Fax
(217) 937-5262
NPI assigned
Dec 14, 2006
Last updated
Sep 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Authorized official

Name
Mr. Paul Skowron
Title
Ceo Adminsitrator
Phone
(217) 935-9571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 0001164 IL Primary

Addresses

Primary practice location

422 W White St
Clinton, IL 61727-2272

Mailing address

422 W White St
Clinton, IL 61727-2272
Phone (217) 935-9571

Other names 1

  • Warner Hospital and Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091117000530 IL Part A Provider - Rural Health Clinic 0042203127 Practice locations: Clinton, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366504565. Details of each certification follow.

Rural health clinic certification: CCN 143404

Legal name
CITY OF CLINTON
Doing business as
WARNER HOSPITAL & HEALTH SERVICES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 3, 1995
Last certification
Jan 15, 2021
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
422 W White St
Clinton, IL 61727-2272
Related CCNs
141303

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

Other NPIs with the same Medicare PAC ID 2

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

  • City of Clinton

    dba Warner Hospital and Health Services

    • Critical Access Hospital
    • Clinton, IL
    • NPI 1235211301

    0042203127

    Same PAC ID
  • City of Clinton

    dba Warner Hospital and Health Services

    • Critical Access Hospital
    • Clinton, IL
    • NPI 1275695470

    0042203127

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Dr John Warner Hospital5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
City of Clinton Organization, Clinton, IL 5% Or Greater Direct Ownership Interest Oct 1, 2009 100%
Donna Wisner Individual Corporate OfficerCfo Oct 1, 2009
Paul Skowron Individual Corporate DirectorCeo Feb 1, 2015
W-2 Managing EmployeeCeo Feb 1, 2015

Owners & managing parties with NPI records 2

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

  • City of Clinton

    dba Warner Hospital and Health Services

    • Critical Access Hospital
    • Clinton, IL
    • NPI 1235211301

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Clinton

    dba Warner Hospital and Health Services

    • Critical Access Hospital
    • Clinton, IL
    • NPI 1275695470

    5% Or Greater Direct Ownership Interest

    CMS ownership

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Warner Hospital and Health ServicesClinton, IL, CCN 141303 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2009

Owned or controlled facilities with NPI records 1

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

  • City of Clinton

    dba Warner Hospital and Health Services

    • Critical Access Hospital
    • Clinton, IL
    • NPI 1235211301

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1366504565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 W WHITE ST",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272272",
            "telephone_number": "217-935-9571",
            "fax_number": "217-937-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 W WHITE ST",
            "city": "CLINTON",
            "state": "IL",
            "postal_code": "617272272",
            "telephone_number": "217-935-9571",
            "fax_number": "217-937-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CLINTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "SKOWRON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO ADMINSITRATOR",
        "authorized_official_telephone_number": "217-935-9571",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IL",
            "license": "0001164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warner Hospital and Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, IL

Sources for this page

Verify at the official NPI Registry.