NPIMap

Organization Active NPI

Carlinville Area Hospital Association

Doing business as Virden Family Health Care

  • Rural Health Clinic/Center
  • Virden, IL
National Provider Identifier
1447691571
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CARLINVILLE AREA HOSPITAL ASSOCIATION
Doing business as
Virden Family Health Care
Practice address
1611 N Springfield St
Virden, IL 62690
Phone
(217) 854-3819
Fax
(217) 965-7113
NPI assigned
Jul 17, 2013
Last updated
Jun 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CARLINVILLE AREA HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Brian D. Burnside
Title
Ceo
Phone
(217) 854-3141

Specialties & licenses 1

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

Addresses

Primary practice location

1611 N Springfield St
Virden, IL 62690

Mailing address

20733 N Broad St
Carlinville, IL 62626-3710
Phone (217) 854-3141

Other names 1

  • Virden Family Health Care Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031104000520 IL Part B Supplier - Clinic/Group Practice 9032021373 Receives reassigned benefits from 77 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carlinville, IL; Gillespie, IL; Girard, IL; Virden, IL
O20131017000512 IL Part A Provider - Rural Health Clinic 9032021373 Practice locations: Virden, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447691571. Details of each certification follow.

Rural health clinic certification: CCN 148532

Legal name
CARLINVILLE AREA HOSPITAL ASSOCIATION
Doing business as
VIRDEN FAMILY HEALTH CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 12, 2014
Last certification
Feb 12, 2014
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1611 N Springfield St
Virden, IL 62690-9781
Related CCNs
141347

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2317921Virden Family Health Care1611 N Springfield St, Virden, IL 62690Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Carlinville Area Hospti10 organizations share this tax ID, including this one
Part of
Carlinville Area Hospti

Other organizations with this tax ID 9

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

Locations

1115 Morgan St
#2
Carlinville, IL 62626
Phone (217) 854-3881

807 Broadway St
Gillespie, IL 62033
Phone (217) 839-3900

205 S 3rd St
Girard, IL 62640
Phone (217) 627-2141

1611 N Springfield St
Virden, IL 62690
Phone (217) 854-3819

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Jay Hodges Individual Corporate OfficerCfo Nov 1, 2024
Richard Walden Individual Corporate DirectorBoard Member Jan 1, 2002
Jim Salske Individual Corporate DirectorBoard Member Jul 1, 2001
Brian D Burnside Individual Corporate OfficerCeo/President Aug 1, 2020
W-2 Managing EmployeeCeo Aug 1, 2020
Operational/Managerial ControlCeo/President Aug 1, 2020
Katie M Goodman-Thomas Individual Corporate DirectorBoard Member Jan 1, 2022
Heather Anne Deneve Individual Corporate DirectorBoard Treasurer Jan 1, 2018
Middle Macoupin Healthcare Systems, Inc. Organization, Carlinville, IL 5% Or Greater Indirect Ownership Interest Aug 1, 2013 100%
Tom Denby Individual Corporate DirectorBoard Member Jan 1, 2022
Dennis Pickrel Individual Corporate DirectorBoard Member Jan 1, 2013
Carlinville Area Hospital Association Organization, Carlinville, IL Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2013 100%
Kristin Boldt Individual Corporate DirectorAssistant Cfo and Revenue Cycle Dir Feb 11, 2025

Owners & managing parties with NPI records 6

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
Carlinville Family Health CareCarlinville, IL, CCN 148530 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jun 18, 2013
Nov 26, 2002

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 3

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

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1447691571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20733 N BROAD ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626263710",
            "telephone_number": "217-854-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 N SPRINGFIELD ST",
            "city": "VIRDEN",
            "state": "IL",
            "postal_code": "62690",
            "telephone_number": "217-854-3819",
            "fax_number": "217-965-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLINVILLE AREA HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CARLINVILLE AREA HOSPITAL ASSOCIATION",
        "enumeration_date": "2013-07-17",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "BURNSIDE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-854-3141"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Virden Family Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Virden Family Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virden, IL

Sources for this page

Verify at the official NPI Registry.