NPIMap

Ferrell Hospital Community Foundation

Organization Active NPI Rural Health Clinic/Center · MC Leansboro, IL

NPI 1689217820 · NPPES record last updated May 22, 2025

Key facts

NPI
1689217820
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Practice address
206 S Washington Street
MC Leansboro, IL 62859-1139
Phone
(618) 643-2835
Fax
(618) 643-2891
NPI assigned
Oct 21, 2019
Organization subpart
No

Authorized official

Name
Vickie Lindstrom, RN BSN
Title
Clinic Practice Manager
Phone
(618) 643-2855

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 9

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 9

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 28

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

View all 28

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 66

Affiliated clinicians 236

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

View all 236

Medicare Care Compare: Hospital

Listed as
Ferrell Hospital Community Foundations CCN 141324
Overall star rating
★☆☆☆☆ 1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (3 enrollments) in IL

Hospital certification: CCN 141324

Legal name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
FERRELL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Feb 1, 2003
Last certification
Jan 29, 2020
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Mar 31, 2004 in IL
Enrollment address
1201 Pine St
Eldorado, IL 62930-1634
Other Hospital Practice Location

Rural health clinic certification: CCN 148616

Legal name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
MCLEANSBORO FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 26, 2020
Last certification
Mar 26, 2020
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Mar 31, 2004 in IL
Enrollment address
206 S Washington St
Ste a
MC Leansboro, IL 62859-5607
Related CCNs
141324

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
Rachael Prather
Individual 		W-2 Managing Employee
Chief Nursing Officer		 Mar 26, 2015 5%
Contracted Managing Employee
Ad;		 May 1, 2025 20%
Ayn Bartok
Individual 		Corporate Director
Director		 Apr 1, 2018
Corporate Director
Board Member		 Apr 1, 2018 5.55%
E. T. Seely
Individual 		Corporate Director
Board Member		 Sep 23, 2009
Corporate Director
Board Member		 Sep 23, 2009 5%
Jeffrey R Campbell
Individual 		Corporate Director
Director		 Jan 1, 2019
Corporate Officer
Board Member		 Jan 1, 2019
Barb Devous
Individual 		Corporate Director
Board Member		 Oct 17, 2013
Corporate Director
Board Member		 Oct 17, 2013 5.55%
Austin Rahmoeller
Individual 		Corporate Director
Director		 Jun 1, 2019
Clifford E Morris
Individual 		Corporate Director
Chairman of the Board		 Jan 28, 2014
Corporate Director
Director of the Board		 Sep 23, 2009 5.55%
Deaconess Health System Inc
Organization · Evansville, IN
Corporation, Non-profit 		Operational/Managerial Control Feb 25, 2016 20%
Nathan Oldham
Individual 		Corporate Director Jul 1, 2013
Corporate Director
Board Member		 Jul 1, 2013 5.55%
Deaconess Regional Healthcare Network Illinois LLC
Organization · Evansville, IN
LLC 		Operational/Managerial Control Feb 25, 2016 20%
Jodie a Smith
Individual 		W-2 Managing Employee
PFS Director		 Jan 28, 2014
W-2 Managing Employee
Revenue Cycle Director		 Jun 1, 1992
Deaconess Regional Healthcare Services Illinois Inc
Organization · Evansville, IN
Corporation, Non-profit 		Operational/Managerial Control Feb 25, 2016 100%
James Porter
Individual 		Corporate Director
Board Member		 Feb 25, 2016 10%
Corporate Director
Board Member		 Jun 7, 2017 5.55%
Marc J Florence
Individual 		Corporate Director
Board Member		 Feb 27, 1975 5.55%
Nikki Rosser
Individual 		Corporate Director
Board Member		 Apr 9, 2014 5.55%

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Ferrell Hospital
Eldorado, IL · CCN 14Z324		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2005
Eldorado Family Medicine Clinic
Eldorado, IL · CCN 148507		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2005

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20061104000493 IL Part a Provider - Critical Access Hospital 1355389453 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: MC Leansboro, IL; Harrisburg, IL; Eldorado, IL; Carmi, IL
O20090630000256 IL Part B Supplier - Clinic/Group Practice 1355389453 Receives reassigned benefits from 74 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Harrisburg, IL; MC Leansboro, IL; Eldorado, IL; Carmi, IL
O20191206000064 IL Part a Provider - Rural Health Clinic 1355389453 Practice locations: MC Leansboro, IL

National Provider Directory

Tax ID family
Ferrell HSP Comm Foundation (10 organizations share this tax ID)

Locations

1338 IL Highway 1
Ste B
Carmi, IL 62821
Phone 61827333611660

1201 Pine St
Ste 1
Eldorado, IL 62930

716 S Commercial St
Harrisburg, IL 62946
Phone (618) 273-3361

Specialties & licenses

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

Addresses

Primary practice location

206 S Washington Street
MC Leansboro, IL 62859-1139

Mailing address

1201 Pine St
Eldorado, IL 62930-1634
Phone (618) 273-3361

Other names

  • McLeansboro Family Medicine Doing business as

Other providers in MC Leansboro, IL

All providers in MC Leansboro, IL · Rural Health Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.