NPIMap

Organization Active NPI

Ferrell Hospital Community Foundation

Doing business as Ferrell Hospital Family Practice

  • Rural Health Clinic/Center
  • Eldorado, IL
National Provider Identifier
1457586620
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
Ferrell Hospital Family Practice
Practice address
1306 Maple St
Eldorado, IL 62930-1662
Phone
(618) 297-9665
Fax
(618) 297-9638
NPI assigned
May 18, 2009
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
Board Chairman
Phone
(618) 273-3361

Specialties & licenses 1

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

Addresses

Primary practice location

1306 Maple St
Eldorado, IL 62930-1662

Mailing address

1306 Maple St
Eldorado, IL 62930-1662
Phone (618) 297-9665

Other names 1

  • Ferrell Hospital Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20061104000493 IL Part A Provider - Critical Access Hospital 1355389453 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: MC Leansboro, IL; Harrisburg, IL; Eldorado, IL; Carmi, IL
O20090630000256 IL Part B Supplier - Clinic/Group Practice 1355389453 Receives reassigned benefits from 74 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Harrisburg, IL; MC Leansboro, IL; Eldorado, IL; Carmi, IL
O20091008000117 IL Part A Provider - Rural Health Clinic 1355389453 Practice locations: Eldorado, IL

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1457586620. Details of each certification follow.

Hospital certification: CCN 141324

Legal name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
FERRELL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2003
Last certification
Jan 29, 2020
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 31, 2004 in IL
Enrollment address
1201 Pine St
Eldorado, IL 62930-1634
Other Hospital Practice Location

Rural health clinic certification: CCN 148506

Legal name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
FERRELL HOSPITAL FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 1, 2009
Last certification
Mar 14, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 31, 2004 in IL
Enrollment address
1306 Maple St
Eldorado, IL 62930-1662
Related CCNs
141324

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).

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ferrell Hospital Community FoundationsCCN 141324 · All quality measures
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
14D2013023Ferrell Hospital Family Practice - Eldorado D/B/a1306 Maple St, Eldorado, IL 62930Certificate of waiverSep 13, 2026

National Provider Directory

National Provider Directory

Locations

1338 IL Highway 1
Carmi, IL 62821
Phone (618) 380-9321

1306 Maple St
Eldorado, IL 62930
Phone (618) 273-2360

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Rachael Prather Individual W-2 Managing EmployeeChief Nursing Officer Mar 26, 2015 5%
Ayn Bartok Individual Corporate DirectorDirector 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 DirectorDirector Jun 1, 2019
Clifford E Morris Individual Corporate DirectorChairman of the Board Jan 28, 2014
Corporate DirectorBoard Chairman Apr 1, 2009
Deaconess Health System Inc Organization, Evansville, IN Corporation, Non-profit Operational/Managerial Control Feb 25, 2016 20%
Nathan Oldham Individual Corporate Director Jul 1, 2013
Corporate DirectorBoard Member Jul 1, 2013
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
W-2 Managing EmployeePFS Director Jun 6, 1993
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%
Jason Kasiar Individual Corporate DirectorBoard Member Jul 1, 2013

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Ferrell HospitalEldorado, IL, CCN 14Z324 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2005
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 2

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

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 236

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

View all 236

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1457586620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 MAPLE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301662",
            "telephone_number": "618-297-9665",
            "fax_number": "618-297-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 MAPLE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301662",
            "telephone_number": "618-297-9665",
            "fax_number": "618-297-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRELL HOSPITAL COMMUNITY FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-18",
        "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": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "618-273-3361"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ferrell Hospital Family Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ferrell Hospital Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eldorado, IL

Sources for this page

Verify at the official NPI Registry.