St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE

Doing business as

Madison County Rural Health

Practice address

12866 Troxler Ave
Highland, IL 62249-2806

Phone

(618) 651-2600

NPI assigned

Sep 29, 2020

Organization subpart

Yes

Parent organization

ST. JOSEPH'S HOSPITAL, BREESE, OF THE HOSPITAL SISTERS OF THE THIRD ORAs reported in NPPES

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

Authorized official

Name

Mark Duane Evard

Title

VP of Revenue Cycle

Phone

(217) 492-9651

Specialties & licenses 1

Addresses

Other names 1

• Madison County Rural Health Doing business as

Electronic endpoints 1

Tax ID family

St Josephs Hospital Breese4 organizations share this tax ID, including this one

Part of

St Josephs Hospital Breese

Other organizations with this tax ID 3

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

• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  dba HSHS St. Joseph's Hospital

  • Pain Clinic/Center
  • Breese, IL
  • NPI 1205469350
  NPD tax ID
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • Medicare Defined Swing Bed Hospital Unit
  • Breese, IL
  • NPI 1447747316
  NPD tax ID
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • Rural Health Clinic/Center
  • Carlyle, IL
  • NPI 1780047944
  NPD tax ID

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1639786171",
    "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": "618-526-7271",
            "fax_number": "618-526-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12866 TROXLER AVE",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622492806",
            "telephone_number": "618-651-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOSEPH'S HOSPITAL, BREESE, OF THE HOSPITAL SISTERS OF THE THIRD OR",
        "enumeration_date": "2020-09-29",
        "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": "DUANE",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "217-492-9651"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "st_josephs_breeze_toc2203120@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "9515 Holy Cross Ln",
            "city": "Breese",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622303618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Madison County Rural Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Madison County Rural Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emalee Shubert
• Donald E. Smith, CRNA
• Lauren Virginia Smith, PNP
• Southern Illinois Gastroenterology LLC
• Southern Obstetric & Gyneco Associates (Southern OB/GYN-Highland)
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F (HSHS St. Joseph's Hospital -Highland)
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F
• St Josephs Hospital of the Hospital Sisters of the Third Order of St F

• Rural Health Clinic/Center in Highland, IL
• Providers in Highland, IL by specialty
• Rural Health Clinic/Center 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.