Jersey County Health Department

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1001577 Issued in IL

Legal business name

JERSEY COUNTY HEALTH DEPARTMENT

Practice address

1307 State Highway 109
Jerseyville, IL 62052

Phone

(618) 498-9565

Fax

(618) 498-6291

NPI assigned

Jul 29, 2005

Last updated

Oct 16, 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

Mrs. Heidi Carter, RN

Title

Public Health Administrator

Phone

(618) 498-9565

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649270729. Details of each certification follow.

• CCN 147063 Home health agency · Active · Details

Home health agency certification: CCN 147063

Legal name

JERSEY COUNTY HEALTH DEPARTMENT

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 1, 1966

Last certification

Mar 25, 2021

Ownership / control type

Government Operated

Organization structure

GovernmentProprietary

Enrollment address

1307 State Highway 109
Jerseyville, IL 62052-2396

Other NPIs on the same Medicare enrollment 1

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

• Jersey County Health Department

  • Clinic/Center
  • Jerseyville, IL
  • NPI 1730842873

  O20050330000423

  Same enrollment

Listed as

Jersey County Health DeptCCN 147063 · All quality measures

Overall star rating

2 of 5

Ownership

Government Operated

Certified

Jul 1, 1966

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Occupational therapy

Tax ID family

Jersey County Health Department2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Jersey County Health Department

  • Clinic/Center
  • Jerseyville, IL
  • NPI 1730842873
  NPD tax ID

Locations

All disclosed owners & managing parties 3

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

Affiliated clinicians 5

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

• Lester A Crancer, DO

  • Internal Medicine Physician
  • Jerseyville, IL
  • NPI 1285682864

  Home health agency

  Care Compare affiliation
• Leoncio S Dizon, MD

  • Internal Medicine Physician
  • Jerseyville, IL
  • NPI 1114982352

  Home health agency

  Care Compare affiliation
• Cristy A Elving-Dial, MD

  • Family Medicine Physician
  • Jerseyville, IL
  • NPI 1922056506

  Home health agency

  Care Compare affiliation
• Donald E Murray, MD

  • Internal Medicine Physician
  • Jerseyville, IL
  • NPI 1659374239

  Home health agency

  Care Compare affiliation
• John L Palcheff, DO

  • Family Medicine Physician
  • Jerseyville, IL
  • NPI 1760442032

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1649270729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 STATE HIGHWAY 109",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522396",
            "telephone_number": "618-498-9565",
            "fax_number": "618-498-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 STATE HIGHWAY 109",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "62052",
            "telephone_number": "618-498-9565",
            "fax_number": "618-498-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "PUBLIC HEALTH ADMINISTRATOR",
        "authorized_official_telephone_number": "618-498-9565",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1001577",
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL HEALTH DEPARTMENT",
            "identifier": "10906700",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jersey Community Hospital (JCH Medical Group - Jerseyville)
• Jersey Community Hospital District (JCH Medical Group)
• Jersey Community Hospital District (jersey community hospital)
• Jersey Community Hospital District (Jersey Community Hospital)
• Jersey County Anesthesia Group LTD
• Jersey County Health Department
• Jersey Family Vision Care, LTD
• Jerseyville Chiropractic and Rehab LLC (Williams Chiropractic)
• Jerseyville Dental Group LLC
• Jerseyville Estates

• Home Health Agency in Jerseyville, IL
• Providers in Jerseyville, 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 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.