NPIMap

Organization Active NPI

Thomas H. Boyd Memorial Hospital

  • Critical Access Hospital
  • Carrollton, IL
National Provider Identifier
1811096811
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
0002782 Issued in IL
Legal business name
THOMAS H. BOYD MEMORIAL HOSPITAL
Practice address
800 School St
Carrollton, IL 62016-1436
Phone
(217) 942-6946
Fax
(217) 942-9349
NPI assigned
Sep 22, 2006
Last updated
Apr 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Stace Holland
Title
Ceo
Phone
(217) 942-6946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0002782 IL Primary

Addresses

Primary practice location

800 School St
Carrollton, IL 62016-1436

Mailing address

800 School St
Carrollton, IL 62016-1436
Phone (217) 942-6946

Other names 1

  • Boyd Healthcare Services Other name

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20041216000800 IL Part B Supplier - Clinic/Group Practice 8123085560 Receives reassigned benefits from 36 practitioners
Practice locations: Carrollton, IL
O20110118000703 IL Part A Provider - Critical Access Hospital 8123085560 Receives reassigned benefits from 22 practitioners
Practice locations: Carrollton, IL
O20110118000988 IL Part A Provider - Critical Access Hospital 8123085560 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carrollton, IL

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1811096811. Details of each certification follow.

Hospital certification: CCN 141300

Legal name
THOMAS H BOYD MEMORIAL HOSPITAL
Doing business as
BOYD HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 12, 1999
Last certification
Mar 22, 2022
Beds
25
Ownership / control type
Local
Organization structure
CorporationNon-profit
Incorporated
May 6, 1940 in IL
Enrollment address
800 School Street
Carrollton, IL 62016-1436
Other Hospital Practice Location

Hospital certification: CCN 14Z300

Legal name
THOMAS H BOYD MEMORIAL HOSPITAL
Doing business as
BOYD HEALTHCARE SERVICES
Organization structure
CorporationNon-profit
Enrollment address
800 School St
Carrollton, IL 62016-1436

Hospital certification: CCN 140188

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
THOMAS H BOYD MEMORIAL HOSPITAL
Certification status
Terminated Other: provider status change, Jul 12, 1999
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 21, 1994
Beds
61
Ownership / control type
Other
Facility address
800 School Street
Carrollton, IL 62016

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Thomas H Boyd Memorial HospitalCCN 141300 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

712 College St
Greenfield, IL 62044
Phone (217) 368-3041

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Jenny Clough Individual Corporate DirectorBoard of Trustees Jul 1, 2022
Corporate Director Jul 1, 2022
Raymond Beavers Individual Corporate DirectorBoard of Trustees Feb 1, 2016
Kathryn Garner Individual Corporate OfficerCfo Jan 13, 2023
W-2 Managing EmployeeCfo Jan 13, 2023
Operational/Managerial ControlCfo Jan 13, 2023
Mary Tunison Individual Corporate DirectorBoard of Trustees Jun 17, 2002
Diane Wolfley Individual Corporate DirectorBoard of Trustees Dec 1, 2004
Stacy D Holland Individual Corporate OfficerCeo Apr 22, 2024
W-2 Managing EmployeeAd; Apr 22, 2024
Operational/Managerial ControlCeo Apr 22, 2024
Mary Plummer Individual Corporate DirectorBoard of Trustees Dec 1, 2018
Kirby Ballard Individual Corporate DirectorBoard of Trustees Sep 25, 2017

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Greene County Rural Health ClinicCarrollton, IL, CCN 143403 Rural health clinic Operational/Managerial Control Jun 21, 2010

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 42

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 42

Affiliated clinicians 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1811096811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCHOOL ST",
            "city": "CARROLLTON",
            "state": "IL",
            "postal_code": "620161436",
            "telephone_number": "217-942-6946",
            "fax_number": "217-942-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCHOOL ST",
            "city": "CARROLLTON",
            "state": "IL",
            "postal_code": "620161436",
            "telephone_number": "217-942-6946",
            "fax_number": "217-942-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS H. BOYD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "STACE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-942-6946"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IL",
            "license": "0002782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boyd Healthcare Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carrollton, IL

Sources for this page

Verify at the official NPI Registry.