HSHS Good Shepherd Hospital Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1007384 Issued in IL

Legal business name

HSHS GOOD SHEPHERD HOSPITAL INC

Practice address

200 South Cedar
Shelbyville, IL 62565

Phone

(217) 774-4499

Fax

(217) 774-6416

NPI assigned

Jul 27, 2005

Last updated

Oct 31, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark D Evard

Title

VP of Revenue Cycle

Phone

(217) 492-9651

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• HSHS Good Shepherd Hospital Inc

  • Critical Access Hospital
  • Shelbyville, IL
  • NPI 1053348532

  O20040327000037

  Same enrollment
• HSHS Good Shepherd Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Shelbyville, IL
  • NPI 1336150028

  O20040327000037

  Same enrollment
• HSHS Good Shepherd Hospital Inc

  dba Shelby Memorial Hospital N H

  • Skilled Nursing Facility
  • Shelbyville, IL
  • NPI 1376557983

  O20040327000037

  Same enrollment
• HSHS Good Shepherd Hospital Inc

  • Oxygen Equipment & Supplies (DME)
  • Shelbyville, IL
  • NPI 1528092186

  O20040327000037

  Same enrollment
• HSHS Good Shepherd Hospital Inc

  • Rural Health Clinic/Center
  • Shelbyville, IL
  • NPI 1750350922

  O20040327000037

  Same enrollment

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1477553998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450",
            "telephone_number": "217-774-3961",
            "fax_number": "217-774-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SOUTH CEDAR",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "62565",
            "telephone_number": "217-774-4499",
            "fax_number": "217-774-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSHS GOOD SHEPHERD HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-27",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "EVARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "217-492-9651"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1007384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD OF IL",
            "identifier": "9981",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "14D09002212",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE/REG #",
            "identifier": "1007384",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacy D. Houska, SLP
• HSHS Good Shephard Hospital
• HSHS Good Shepherd Hospital Inc
• HSHS Good Shepherd Hospital Inc
• HSHS Good Shepherd Hospital Inc (Shelby Memorial Hospital N H)
• HSHS Good Shepherd Hospital Inc
• HSHS Good Shepherd Hospital Inc
• Illinois Emergency Staffing Solutions, Inc.
• In Bloom Wellness PLLC
• Brenda Lou Isermann

• Home Health Agency in Shelbyville, IL
• Providers in Shelbyville, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.