NPIMap

Organization Active NPI

HSHS Medical Group Inc

Doing business as Quick Care - Powered by HSHS Medical Group

  • Rural Health Clinic/Center
  • Newton, IL
National Provider Identifier
1679236533
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HSHS MEDICAL GROUP INC
Doing business as
Quick Care - Powered by HSHS Medical Group
Practice address
601 W Washington St # 1
Newton, IL 62448-1264
Phone
(618) 783-0954
Fax
(618) 783-0958
NPI assigned
Oct 18, 2021
Last updated
Aug 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Andrew Watson
Title
Cfo
Phone
(217) 492-5806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

601 W Washington St # 1
Newton, IL 62448-1264

Mailing address

3051 Hollis Dr FL 2
Springfield, IL 62704-7450

Other names 1

  • Quick Care - Powered by HSHS Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211229001346 IL Part A Provider - Rural Health Clinic 5092857821 Practice locations: Newton, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679236533. Details of each certification follow.

Rural health clinic certification: CCN 783848

Legal name
HSHS MEDICAL GROUP INC
Doing business as
QUICK CARE - POWERED BY HSHS MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 11, 2019
Last certification
Dec 11, 2019
Ownership / control type
1B
Most recent change of ownership
Oct 31, 2021 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 13, 2009 in IL
Enrollment address
601 W Washington St
Ste 1
Newton, IL 62448

Other NPIs with the same Medicare PAC ID 8

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

  • HSHS Prairie, Inc

    dba HSHS Medical Group Family Medicine - Dieterich

    • Rural Health Clinic/Center
    • Dieterich, IL
    • NPI 1033841192

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc

    dba HSHS Medical Group Family & Internal Medicine - Effingham

    • Rural Health Clinic/Center
    • Effingham, IL
    • NPI 1265904486

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc

    dba HSHS Prairie Foot and Ankle - Springfield

    • Durable Medical Equipment & Medical Supplies
    • Springfield, IL
    • NPI 1467849257

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc

    dba HSHS Prairie Foot and Ankle - Jacksonville

    • Durable Medical Equipment & Medical Supplies
    • Jacksonville, IL
    • NPI 1629465414

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc

    dba HSHS Medical Group Family Medicine - Altamont

    • Rural Health Clinic/Center
    • Altamont, IL
    • NPI 1679108351

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc

    dba HSHS Prairie Foot and Ankle - Breese

    • Durable Medical Equipment & Medical Supplies
    • Breese, IL
    • NPI 1740677533

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc

    dba HSHS Medical Group Inc

    • Rural Health Clinic/Center
    • Highland, IL
    • NPI 1851536296

    5092857821

    Same PAC ID
  • HSHS Prairie, Inc
    • Multi-Specialty Clinic/Center
    • Springfield, IL
    • NPI 1962644807

    5092857821

    Same PAC ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2162519Quick Care Powered by Hshsmg601 W Washington St - Ste 1, Newton, IL 62448Certificate of waiverFeb 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
HSHS Medical Group18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

601 W Washington St
#1
Newton, IL 62448
Phone (618) 783-0954

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Hospital Sisters Health System Inc Organization, Springfield, IL Corporation 5% Or Greater Direct Ownership Interest May 1, 2021 100%
Marc Edward Shelton Individual Corporate DirectorBoard Member Nov 1, 2021
Jerry Gaffner Individual Corporate DirectorBoard Member Nov 1, 2021
Heather Spath Individual Corporate OfficerManager Medical Staff Nov 1, 2021
Corporate DirectorManager Medical Staff Nov 1, 2021
W-2 Managing EmployeeManager Medical Staff Nov 1, 2021
Andrew D Watson Individual Corporate OfficerCfo Nov 1, 2021
Corporate DirectorCfo Nov 1, 2021
W-2 Managing EmployeeCfo Nov 1, 2021
Timothy Nicoud Individual Corporate DirectorBoard Member Nov 1, 2021
Damond Williams Boatwright Individual Corporate DirectorBoard Member Nov 1, 2021
Frank L Mikell Individual Corporate DirectorBoard Member Nov 1, 2021
Melinda Clark Individual Corporate OfficerCeo Nov 1, 2021
Corporate DirectorCeo Nov 1, 2021
W-2 Managing EmployeeCeo Nov 1, 2021
Dona S McGraw Individual Corporate DirectorBoard Member Nov 1, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 19

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

View all 19

Change-of-ownership history 1

DateEventCounterparty
Oct 31, 2021 Change of OwnershipThis provider was the buyer Mid Illinois Quick CareCCN 783848, IL, NPI 1871159053

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1679236533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR FL 2",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W WASHINGTON ST # 1",
            "city": "NEWTON",
            "state": "IL",
            "postal_code": "624481264",
            "telephone_number": "618-783-0954",
            "fax_number": "618-783-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSHS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "217-492-5806"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quick Care - Powered by HSHS Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quick Care - Powered by HSHS Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newton, IL

Sources for this page

Verify at the official NPI Registry.