NPIMap

Organization Active NPI

Jersey Community Hospital District

Doing business as Jersey Community Hospital

  • Anesthesiology Physician
  • Jerseyville, IL
National Provider Identifier
1780617530
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
001156 Issued in ID
Legal business name
JERSEY COMMUNITY HOSPITAL DISTRICT
Doing business as
Jersey Community Hospital
Practice address
400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone
(618) 498-6402
NPI assigned
Jul 7, 2006
Last updated
Mar 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Authorized official

Name
Michelle Hopper
Title
Cfo
Phone
(618) 498-8349

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 001156 ID Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 001156 IL
Certified Registered Nurse Anesthetist 367500000X 001156 IL

Addresses

Primary practice location

400 Maple Summit Rd
Jerseyville, IL 62052-2028

Mailing address

400 Maple Summit Rd
Jerseyville, IL 62052-2028

Other names 2

  • Jersey Community Hospital Doing business as
  • JCH HealthCare Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040424000140 IL Part B Supplier - Clinic/Group Practice 4587650445 Receives reassigned benefits from 65 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carrollton, IL; Hardin, IL; Jerseyvile, IL; Jerseyville, IL; Roodhouse, IL

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Jersey Community Hospital District13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

523 S Main St
Carrollton, IL 62016
Phone (217) 348-3326

270 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-7108

Practitioners & affiliated clinicians

Practitioners 34

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 34

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741132800000",
    "number": "1780617530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522028",
            "telephone_number": "618-498-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY COMMUNITY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A",
        "authorized_official_last_name": "HOPPER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "618-498-8349"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ID",
            "license": "001156",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "001156",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "001156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jersey Community Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JCH HealthCare",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jerseyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.