Morrison Community Hospital District
Organization Active NPI Family Medicine Physician · Morrison, IL
NPI 1700907250 · NPPES record last updated Dec 9, 2024
Key facts
- NPI
- 1700907250
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MORRISON COMMUNITY HOSPITAL DISTRICT
- Practice address
- 303 N Jackson St
Morrison, IL 61270-3042 - Phone
- (815) 772-5530
- Fax
- (815) 772-7391
- NPI assigned
- Apr 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Pam Pfister
- Title
- Ceo
- Phone
- (812) 772-5530
Owned or controlled facilities with NPI records 4
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 5
Practitioners 45
-
Michelle Ann Blackmer, APRN
-
Suraj Bopanna, MD, MRCP
-
Steven Braasch, M.S.ED., LCPC
-
Abdullah Foad, MD
-
Priyanka Gauravi, M.D.
-
Asad Jamal, M.D.
-
Katie Kasper, NP-C
-
Christina Lutz, LCPC
-
Faraz Manazir, M.D.
-
Mathew C Mathew, MD
-
Micah W McNeill, APRN, CNP
-
Marcella Alene Miner, DNP, APRN
-
Anand K Patel, M.D.
-
Catherine Marie Perino, APRN
-
Robb V Rydzynski, D.O.
-
Teresa Ann Stout, RN, BSN, CDE
-
Trever Troutman, MD
-
Ava Diane Valdez, PAC
-
Jessica West, LCSW
-
Bridgette Ann Woodall, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Morrison Community Hospital District |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Morrison Community Hospital District |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Morrison Community Hospital District |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Morrison Community Hospital Erie Clinic |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) | Jun 30, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040301000685 | IL | Part B Supplier - Clinic/Group Practice | 2466349907 |
Receives reassigned benefits from 38 practitioners 3 other NPIs on this enrollment Practice locations: Dixon, IL; Moline, IL; Morrison, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Critical Access Hospital | 282NC0060X | 0001636 | IL | |
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
303 N Jackson St
Morrison, IL 61270-3042
Mailing address
303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-5530
Other providers in Morrison, IL
- Morr Fitz Inc
- Morrison Community Hospital
- Morrison Community Hospital
- Morrison Community Hospital District
- Morrison Community Hospital District
- Morrison Community Hospital District
- Morrison Community Hospital District
- Morrison Cusd 6
- Morrison Nursing and Rehab Center LLC
- Tristan Munroe
All providers in Morrison, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.