NPIMap

Organization Active NPI

Crawford Hospital District

Doing business as Crawford Memorial Hospital and Health Services

  • Medicare Defined Swing Bed Hospital Unit
  • Robinson, IL
National Provider Identifier
1700842887
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
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
Medicare Defined Swing Bed Hospital Unit 275N00000X 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
O20080129000693 IL Part A Provider - Critical Access Hospital 7719898071 Receives reassigned benefits from 3 practitioners
Practice locations: Robinson, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700842887. Details of each certification follow.

Hospital certification: CCN 14Z343

Legal name
CRAWFORD HOSPITAL DISTRICT
Doing business as
CRAWFORD MEMORIAL HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
1000 N Allen St
Robinson, IL 62454-1114

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

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Douglas C Florkowski Individual Contracted Managing EmployeeCeo Jul 17, 2017
Albert Nicholas White Individual Contracted Managing EmployeeCfo Apr 17, 2019
Judith K Adams Individual Corporate DirectorBoard Member Jan 1, 2005
Mitzi S Martin Individual Corporate DirectorBoard Member/Chairman/ 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 DirectorBoard Member Jan 1, 2004
Julia M Hoalt Individual W-2 Managing EmployeeRevenue Cycle Director and Deleg Aug 9, 2017
Crawford Hospital District Organization, Robinson, IL Operational/Managerial Control Aug 9, 2017 100%
Melissa York Individual Corporate DirectorBoard Member Jul 1, 2024
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 Hospital Home HealthRobinson, IL, CCN 147175 Home health agency 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

Practitioners 3

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.

Affiliated clinicians 4

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": "1700842887",
    "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "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.