NPIMap

Organization Active NPI

County of Henry

Doing business as First Choice Healthcare

  • State or Local Public Health Clinic/Center
  • Kewanee, IL
National Provider Identifier
1851394829
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
COUNTY OF HENRY
Doing business as
First Choice Healthcare
Henry County Health Department
Practice address
110 N Burr Blvd
Kewanee, IL 61443-2214
Phone
(309) 852-0197
Fax
(098) 545-5753
NPI assigned
May 24, 2005
Last updated
Apr 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Authorized official

Name
Tara Lafollette
Title
Insurance Billing
Phone
(309) 852-0197

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Non-Surgical Family Planning Clinic/Center 261QF0050X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
State or Local Public Health Clinic/Center 261QP0905X Primary
Homemaker 376J00000X
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

110 N Burr Blvd
Kewanee, IL 61443-2214

Mailing address

110 N Burr Blvd
Kewanee, IL 61443-2214
Phone (309) 852-0197

Other practice location 1

103 1st St
Colona, IL 61241-9742
Phone (309) 792-4011

Other practice location 2

120 E Court St
Toulon, IL 61483-5388
Phone (309) 852-3115

Other identifiers 3

IdentifierTypeStateIssuer
DH1819OtherILMEDICARE RR
241300OtherILMEDICARE PART B
3721776OtherILBCBS

Other names 2

  • First Choice Healthcare Doing business as
  • Henry County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070306000229 IL Part B Supplier - Clinic/Group Practice 5193828556 Receives reassigned benefits from 10 practitioners
Practice locations: Colona, IL; Toulon, IL; Kewanee, IL
O20190613000110 IL Part A Provider - Rural Health Clinic 5193828556 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kewanee, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851394829. Details of each certification follow.

Rural health clinic certification: CCN 783852

Legal name
COUNTY OF HENRY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 9, 2021
Last certification
Jun 9, 2021
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
110 N Burr Blvd
Kewanee, IL 61443-2214

Other NPIs with the same Medicare PAC ID 2

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.

National Provider Directory

National Provider Directory

Locations

4424 US Highway 34
Kewanee, IL 61443
Phone (309) 852-0197

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Kelli Humphrey Individual W-2 Managing Employee Jul 1, 2019
Duane Stevens Individual Corporate DirectorAdministrator Jul 1, 2019
W-2 Managing Employee Jul 1, 2019

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hillcrest HomeGeneseo, IL, CCN 145949 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Sep 28, 2011
Sep 28, 2011
Sep 28, 2011
Sep 28, 2011

Owned or controlled facilities with NPI records 1

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

  • Hillcrest Home
    • Skilled Nursing Facility
    • Geneseo, IL
    • NPI 1770582330

    5% Or Greater Direct Ownership Interest, 5% Or Greater Security Interest, Adp of the SNF, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1851394829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N BURR BLVD",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614432214",
            "telephone_number": "309-852-0197",
            "fax_number": "098-545-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N BURR BLVD",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614432214",
            "telephone_number": "309-852-0197",
            "fax_number": "098-545-5753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 1st St",
            "address_purpose": "LOCATION",
            "city": "Colona",
            "state": "IL",
            "postal_code": "612419742",
            "country_code": "US",
            "telephone_number": "309-792-4011",
            "fax_number": "309-792-4013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 E Court St",
            "address_purpose": "LOCATION",
            "city": "Toulon",
            "state": "IL",
            "postal_code": "614835388",
            "country_code": "US",
            "telephone_number": "309-852-3115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COUNTY OF HENRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "LAFOLLETTE",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "INSURANCE BILLING",
        "authorized_official_telephone_number": "309-852-0197"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DH1819",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "241300",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3721776",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Henry County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kewanee, IL

Sources for this page

Verify at the official NPI Registry.