NPIMap

Organization Active NPI

Franklin Hospital District

  • Rural Health Clinic/Center
  • West Frankfort, IL
National Provider Identifier
1376861385
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FRANKLIN HOSPITAL DISTRICT
Practice address
309 W Saint Louis St Ste B
West Frankfort, IL 62896-2047
Phone
(618) 932-2200
Fax
(618) 932-2202
NPI assigned
May 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Mr. Jim Johnson
Title
Ceo
Phone
(618) 439-3161

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0005231 IL
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

309 W Saint Louis St Ste B
West Frankfort, IL 62896-2047

Mailing address

201 Bailey LN
Benton, IL 62812-1969
Phone (618) 439-3161

Other identifiers 1

IdentifierTypeStateIssuer
209232OtherILMEDICARE P-TAN PROFESSIONAL FEE

Other names 1

  • West Frankfort Family Healthcare Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100804001051 IL Part A Provider - Rural Health Clinic 4082516042 Practice locations: West Frankfort, IL

Rural health clinic certification: CCN 148510

Legal name
FRANKLIN HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 23, 2010
Last certification
Mar 23, 2022
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Incorporated
Sep 25, 1950 in IL
Enrollment address
309 W Saint Louis St
Ste B
West Frankfort, IL 62896-2047
Related CCNs
141321

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Franklin 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.

Locations

309 W Saint Louis St
Ste B
West Frankfort, IL 62896
Phone (618) 932-2200

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
James M Johnson Individual Corporate OfficerCeo Aug 1, 2016
Operational/Managerial ControlCeo Jul 1, 2016
Rikki Bonthron Individual Corporate OfficerCfo Jul 1, 2017
Corporate DirectorController Jun 5, 2005
Gayla Kain Individual Corporate DirectorBoard Member Aug 10, 2014
Keith Ing Individual Corporate DirectorBoard Member Sep 1, 2019
Robert Lewis Individual Corporate DirectorBoard Member Aug 9, 2013
Jim Johnson Individual Corporate DirectorBoard Member Sep 15, 2016
Brent Young Individual Corporate DirectorBoard Member Aug 20, 2012
Ron Knox Individual Corporate DirectorBoard Member Aug 24, 2021
Don Cruz Individual Corporate DirectorBoard Member Sep 1, 2017
Royann Wilson Individual Corporate DirectorBoard Member Aug 24, 2021

Practitioners & affiliated clinicians

Practitioners 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1376861385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BAILEY LN",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121969",
            "telephone_number": "618-439-3161",
            "fax_number": "618-439-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W SAINT LOUIS ST STE B",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962047",
            "telephone_number": "618-932-2200",
            "fax_number": "618-932-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANKLIN HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-439-3161",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "0005231",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P-TAN PROFESSIONAL FEE",
            "identifier": "209232",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Frankfort Family Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Frankfort Family Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Frankfort, IL

Sources for this page

Verify at the official NPI Registry.