NPIMap

Organization Active NPI

Ferrell Hospital Community Foundation

Doing business as McLeansboro Family Medicine

  • Rural Health Clinic/Center
  • McLeansboro, IL
National Provider Identifier
1689217820
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FERRELL HOSPITAL COMMUNITY FOUNDATION
Doing business as
McLeansboro Family Medicine
Practice address
206 S Washington Street
MC Leansboro, IL 62859-1139
Phone
(618) 643-2835
Fax
(618) 643-2891
NPI assigned
Oct 21, 2019
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Vickie Lindstrom, RN BSNNPI 1891381679
Title
Clinic Practice Manager
Phone
(618) 643-2855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

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 1

  • McLeansboro Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL3 enrollments

Enrollment records 3

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

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1689217820. Details of each certification follow.

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
CorporationNon-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
CorporationNon-profit
Incorporated
Mar 31, 2004 in IL
Enrollment address
206 S Washington St
Ste a
MC Leansboro, IL 62859-5607
Related CCNs
141324

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 9

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Ferrell Hospital Community FoundationsCCN 141324 · All quality measures
Overall star rating
1 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Ferrell HSP Comm Foundation10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1340 IL Highway 1
Carmi, IL 62821

1201 Pine St
Ste 1
Eldorado, IL 62930

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
Rachael Prather Individual W-2 Managing EmployeeChief Nursing Officer Mar 26, 2015 5%
Contracted Managing EmployeeAd; May 1, 2025 20%
Ayn Bartok Individual Corporate DirectorDirector Apr 1, 2018
Corporate DirectorBoard Member Apr 1, 2018 5.55%
E. T. Seely Individual Corporate DirectorBoard Member Sep 23, 2009
Corporate DirectorBoard Member Sep 23, 2009 5%
Jeffrey R Campbell Individual Corporate DirectorDirector Jan 1, 2019
Corporate OfficerBoard Member Jan 1, 2019
Barb Devous Individual Corporate DirectorBoard Member Oct 17, 2013
Corporate DirectorBoard Member Oct 17, 2013 5.55%
Austin Rahmoeller Individual Corporate DirectorDirector Jun 1, 2019
Clifford E Morris Individual Corporate DirectorChairman of the Board Jan 28, 2014
Corporate DirectorDirector 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 DirectorBoard 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 EmployeePFS Director Jan 28, 2014
W-2 Managing EmployeeRevenue 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 DirectorBoard Member Feb 25, 2016 10%
Corporate DirectorBoard Member Jun 7, 2017 5.55%
Marc J Florence Individual Corporate DirectorBoard Member Feb 27, 1975 5.55%
Nikki Rosser Individual Corporate DirectorBoard Member Apr 9, 2014 5.55%

Owners & managing parties with NPI records 3

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

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

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 28

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

View all 28

Practitioners & affiliated clinicians

Practitioners 55

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.

View all 55

Affiliated clinicians 236

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

View all 236

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1689217820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PINE ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301634",
            "telephone_number": "618-273-3361",
            "fax_number": "618-273-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S WASHINGTON STREET",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591139",
            "telephone_number": "618-643-2835",
            "fax_number": "618-643-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRELL HOSPITAL COMMUNITY FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2025-05-22",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "LINDSTROM",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "CLINIC PRACTICE MANAGER",
        "authorized_official_telephone_number": "618-643-2855",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McLeansboro Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McLeansboro Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McLeansboro, IL

Sources for this page

Verify at the official NPI Registry.