NPIMap

Organization Active NPI

Javon Bea Hospital

  • General Acute Care Hospital
  • Rockford, IL
National Provider Identifier
1629118609
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0002048 Issued in IL
Legal business name
JAVON BEA HOSPITAL
Practice address
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone
(815) 971-7000
Fax
(815) 968-4795
NPI assigned
Feb 7, 2007
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Patricia Lynne Allen
Title
Cfo
Phone
(608) 756-6080

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0002048 IL Primary
Clinical Medical Laboratory 291U00000X NU

Addresses

Primary practice location

8201 E Riverside Blvd
Rockford, IL 61114-2300

Mailing address

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000

Other practice location 1

3401 N Perryville Rd
Rockford, IL 61114-8011
Phone (815) 971-5000

Other identifiers 12

IdentifierTypeStateIssuer
090109100MedicaidFL
1400239MedicaidNC
108771105MedicaidAR
0927533MedicaidIA
140239OtherILIL MEDICARE
372OtherBCBS
1121340MedicaidPA
11002400MedicaidWI
720850200MedicaidMN
XHSP30083MedicaidCA
011307204MedicaidMO
100034510AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100510000238 IL Part A Provider - Hospital 1850299967 Practice locations: Belvidere, IL; Byron, IL; Loves Park, IL; Rockford, IL; Winnebago, IL; Roscoe, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629118609. Details of each certification follow.

Hospital certification: CCN 140239

Legal name
JAVON BEA HOSPITAL
Doing business as
JAVON BEA HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 1, 2012
Beds
431
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
8201 E Riverside Blvd
Rockford, IL 61114-2300
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Javon Bea HospitalCCN 140239 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Rockford Memorial HospitalCCN 14T239
Ownership
Non-profit
Certified
Mar 1, 1984

This is a unit of this hospital with its own CMS Certification Number. Care Compare reports it separately, and it has no NPI of its own. How units are connected

National Provider Directory

National Provider Directory
Tax ID family
Javon Bea Hospital8 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Ownership & related parties

All disclosed owners & managing parties 23

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

NameRoleSinceShare
Dave L Syverson Individual Corporate Director Jan 1, 2016
Kathi J Palches Individual W-2 Managing EmployeeFacility Credentialing Coordinator Dec 20, 2017
Ali Olia Individual Corporate OfficerVP Information Systems Nov 1, 2021
W-2 Managing EmployeeVP Information Systems Nov 1, 2021
Kara Sankey Individual Corporate OfficerVP Operations Apr 1, 2021
W-2 Managing EmployeeVP Operations Apr 1, 2021
Jennifer a Hallatt Individual Corporate OfficerVP Operations Jan 1, 2012
W-2 Managing EmployeeVP Operations Jan 1, 2012
Carlos Arevalo Individual Corporate DirectorBoard Member Oct 16, 2024
Mercy Health Corporation Organization, Rockford, IL Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2015 100%
Thomas D Budd Individual Corporate DirectorBoard Secretary/Treasurer Jan 1, 2016
John T Dorsey Individual Corporate OfficerVP & Director of Medical Affairs Aug 20, 2012
W-2 Managing EmployeeVP & Director of Medical Affa Aug 20, 2012
Katherine a Schack Individual Corporate DirectorBoard of Directors - Vice Chair Sep 1, 2016
Joseph Malas Individual Corporate OfficerCfo Jun 1, 2025
W-2 Managing EmployeeCfo Jun 1, 2025
Joanna Benning Individual Corporate OfficerVP Facilities & Construction Mar 15, 2015
W-2 Managing EmployeeVP Facilities & Construction Mar 15, 2015
Robert Brinkerhoff Individual Corporate OfficerVP People & Culture Feb 19, 2024
W-2 Managing EmployeeVP People & Culture Feb 19, 2024
Edward P Cranley Individual Corporate OfficerSenior VP Mercycare Nov 30, 2014
W-2 Managing EmployeeSenior VP Mercycare Nov 30, 2014
Bradley Olson Individual Corporate OfficerVP Managed Care Sep 25, 2023
W-2 Managing EmployeeVP Managed Care Sep 25, 2023
Mark L Goelzer Individual Corporate OfficerVP Medical Staff Affairs Jan 1, 2016
Corporate DirectorDirector of Medical Staff Affairs Jan 1, 2016
W-2 Managing EmployeeVP Medical Staff Affairs Jan 1, 2016
Kimberly Scaccia Individual Corporate OfficerVP Revenue Cycle Mar 23, 2020
W-2 Managing EmployeeVP Revenue Cycle Mar 23, 2020
Wesley M Jost Individual Corporate DirectorBoard of Directors Sep 1, 2016
Tyler Killpack Individual Corporate OfficerVP Community Hospitals Aug 1, 2023
W-2 Managing EmployeeVP Community Hospitals Aug 1, 2023
Amy Whitaker Individual Corporate OfficerVP Supply Chain Aug 1, 2022
W-2 Managing EmployeeVP Supply Chain Aug 1, 2022
Thomas R Pool Individual Corporate DirectorBoard Chair Jan 1, 2016
Ladd Udy Individual Corporate OfficerVP Value Based Care & Pop Health Nov 10, 2018
W-2 Managing EmployeeVP Value Based Care & Pop Hea Nov 10, 2018
Javon R Bea Individual Corporate OfficerPresident/Ceo Jan 1, 2016
Corporate DirectorPresident/Ceo Jan 1, 2016

Owners & managing parties with NPI records 2

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
Van Matre Encompass Health Rehabilitation InstituteRockford, IL, CCN 143028 Hospital 5% Or Greater Indirect Ownership Interest (50%) Jul 31, 2015

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 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 486

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

View all 486

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1629118609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611142300",
            "telephone_number": "815-971-7000",
            "fax_number": "815-968-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 E RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611142300",
            "telephone_number": "815-971-7000",
            "fax_number": "815-968-4795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Perryville Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611148011",
            "country_code": "US",
            "telephone_number": "815-971-5000",
            "fax_number": "815-968-4795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAVON BEA HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH CORPORATION",
        "enumeration_date": "2007-02-07",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "608-756-6080"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0002048",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090109100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1400239",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108771105",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0927533",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL MEDICARE",
            "identifier": "140239",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "372",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1121340",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11002400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720850200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP30083",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011307204",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100034510A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.