NPIMap

Organization Active NPI

Crawford Hospital District

Doing business as Crawford Memorial Hospital and Health Services

  • Home Health Agency
  • Robinson, IL
National Provider Identifier
1669438750
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1001189 Issued in IL
Legal business name
CRAWFORD HOSPITAL DISTRICT
Doing business as
Crawford Memorial Hospital and Health Services
Practice address
1000 N Allen St
Robinson, IL 62454-1167
Phone
(618) 544-3131
Fax
(618) 546-2647
NPI assigned
Apr 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Donald Eugene Annis
Title
Ceo
Phone
(618) 546-2514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1001189 IL Primary

Addresses

Primary practice location

1000 N Allen St
Robinson, IL 62454-1167

Mailing address

1000 N Allen St
Robinson, IL 62454-1167
Phone (618) 544-3131

Other names 1

  • CRAWFORD MEMORIAL HOSPITAL AND HEALTH SERVICES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060531000125 IL Part A Provider - Home Health Agency 7719898071 Practice locations: Robinson, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669438750. Details of each certification follow.

Home health agency certification: CCN 147175

Legal name
CRAWFORD HOSPITAL DISTRICT
Doing business as
CRAWFORD MEMORIAL HOSPITAL HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 1, 1979
Last certification
Jan 9, 2020
Ownership / control type
Proprietary
Organization structure
GovernmentNon-profit
Enrollment address
1108 N Allen St
Ste a
Robinson, IL 62454-1175
HHA Branch

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Crawford Memorial Home HealthCCN 147175 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Aug 1, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Crawford Memorial Emerg11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Julie Brooks Individual W-2 Managing EmployeeHome Health Director Jan 1, 2002
Douglas C Florkowski Individual Contracted Managing EmployeeCeo Jul 17, 2017
Judith K Adams Individual Corporate DirectorBoard Member Jan 1, 2005
Mitzi S Martin Individual Corporate DirectorBoard Member Jan 1, 2004
John W Daugherty Individual Corporate DirectorBoard Member Feb 19, 2009
Robert K Quick Individual Corporate DirectorBoard Member Feb 17, 2021
Stewart J Schutte Individual Corporate DirectorBoard Member Sep 20, 2017
Gregory P Kastner Individual Corporate DirectorBoard Member Feb 15, 2006
W-2 Managing EmployeeMedical Staff MD Feb 15, 2006
Wanda S James Individual Corporate DirectorChairman of the Board Jan 1, 2004
Julia M Hoalt Individual W-2 Managing EmployeeRevenue Cycle Director and Deleg Aug 9, 2017
Claretta K Holscher Individual Corporate DirectorBoard Member Sep 1, 2019
Crawford Hospital District Organization, Robinson, IL Operational/Managerial Control Aug 9, 2017 100%
Melissa York Individual Corporate DirectorBoard Member Jul 1, 2024
John M Harbor Individual Contracted Managing EmployeeCfo May 1, 2023
Thomas a Moore Individual Corporate DirectorBoard Member Mar 21, 2018

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 6

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

FacilityTypeRoleSince
Crawford Memorial HospitalRobinson, IL, CCN 141343 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Crawford Memorial HospitalRobinson, IL, CCN 14Z343 Hospital Operational/Managerial Control (100%) Aug 9, 2017
Crawford Memorial HospitalRobinson, IL, CCN 143429 Rural health clinic Operational/Managerial Control (100%) Aug 16, 2012
CMH Rural Health- OblongOblong, IL, CCN 143488 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control (100%)		 Jul 31, 2006
Aug 6, 2013
CMH Rural Health- PalestinePalestine, IL, CCN 143486 Rural health clinic Operational/Managerial Control (100%) Aug 13, 2013
CMH Rural Health - Med CenterRobinson, IL, CCN 148611 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 29, 2023
Nov 1, 2019

Owned or controlled facilities with NPI records 7

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 10

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

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669438750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N ALLEN ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541167",
            "telephone_number": "618-544-3131",
            "fax_number": "618-546-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N ALLEN ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541167",
            "telephone_number": "618-544-3131",
            "fax_number": "618-546-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANNIS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-546-2514",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1001189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRAWFORD MEMORIAL HOSPITAL AND HEALTH SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Robinson, IL

Sources for this page

Verify at the official NPI Registry.