NPIMap

Organization Active NPI

Hamilton Memorial Hospital District

  • Critical Access Hospital
  • McLeansboro, IL
National Provider Identifier
1447257258
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
0000885 Issued in IL
Legal business name
HAMILTON MEMORIAL HOSPITAL DISTRICT
Practice address
611 S Marshall Ave
MC Leansboro, IL 62859-1213
Phone
(618) 643-2361
Fax
(618) 643-2502
NPI assigned
Jul 7, 2005
Last updated
Aug 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Mr. Justin Epperson
Title
Cfo
Phone
(618) 643-2361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0000885 IL Primary

Addresses

Primary practice location

611 S Marshall Ave
MC Leansboro, IL 62859-1213

Mailing address

611 S Marshall Ave
PO Box 429
MC Leansboro, IL 62859-1213
Phone (618) 643-2361

Other identifiers 1

IdentifierTypeStateIssuer
11370337OtherILBLUE CROSS OF IL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040511001018 IL Part B Supplier - Clinic/Group Practice 6608865985 Receives reassigned benefits from 24 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmi, IL; MC Leansboro, IL
O20070524000235 IL Part A Provider - Critical Access Hospital 6608865985 1 other NPI on this enrollment
Practice locations: Carmi, IL; McLeansboro, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447257258. Details of each certification follow.

Hospital certification: CCN 141326

Legal name
HAMILTON MEMORIAL HOSPITAL DISTRICT
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
May 1, 2003
Last certification
Jul 15, 2025
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
OtherNon-profit
Enrollment address
611S Marshall Ave
McLeansboro, IL 62859-1213
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Hamilton Memorial HospitalCCN 141326 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1112 Oak St
Ste 102
Carmi, IL 62821
Phone (618) 382-5030

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/hamilto-2525a05c

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kenny Aydt Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Greg Muehlenbein Individual Corporate Director Jul 10, 2008 10%
John Warner Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Marilyn Cross Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Paula J Hatfield Individual Corporate Director Jul 31, 2011 10%
Justin Epperson Individual Corporate OfficerCfo Jul 1, 2020
Corporate DirectorCfo Jul 1, 2020
W-2 Managing EmployeeCfo Jul 1, 2020
Jason Waier Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023
Wayne Morris Individual Corporate Director Aug 31, 2011 10%
Kelly Karcher Individual Corporate OfficerBoard Member Jan 1, 2023
Corporate DirectorBoard Member Jan 1, 2023

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hamilton Memorial Family ClinicCarmi, IL, CCN 148529 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2012

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

Affiliated clinicians 72

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

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1447257258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S MARSHALL AVE",
            "address_2": "PO BOX 429",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591213",
            "telephone_number": "618-643-2361",
            "fax_number": "618-643-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S MARSHALL AVE",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591213",
            "telephone_number": "618-643-2361",
            "fax_number": "618-643-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "EPPERSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "618-643-2361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IL",
            "license": "0000885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IL",
            "identifier": "11370337",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McLeansboro, IL

Sources for this page

Verify at the official NPI Registry.