NPIMap

Organization Active NPI

McDonough County Hospital District

Doing business as McDonough District Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Macomb, IL
National Provider Identifier
1851705370
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
MCDONOUGH COUNTY HOSPITAL DISTRICT
Doing business as
McDonough District Hospital
Practice address
525 E Grant St
Macomb, IL 61455-3313
Phone
(309) 833-4101
NPI assigned
Jun 12, 2014
Last updated
Nov 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Authorized official

Name
Kenny Boyd Jr.
Title
Ceo
Phone
(309) 836-1675

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary
General Acute Care Hospital 282N00000X 0001438 IL

Addresses

Primary practice location

525 E Grant St
Macomb, IL 61455-3313

Mailing address

525 E Grant St
Macomb, IL 61455-3313
Phone (309) 833-4101

Other names 1

  • McDonough District Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240313000554 IL Part A Provider - Critical Access Hospital 0446140180 Practice locations: Macomb, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851705370. Details of each certification follow.

Hospital certification: CCN 14U089

Legal name
MCDONOUGH COUNTY HOSPITAL DISTRICT
Doing business as
MCDONOUGH DISTRICT HOSPITAL
Organization structure
GovernmentNon-profit
Incorporated
Mar 16, 1955 in IL
Enrollment address
525 E Grant St
Macomb, IL 61455-3313
Hospital Swing-Bed Unit

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

Other NPIs with the same Medicare PAC ID 10

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 3

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

NameRoleSinceShare
McDonough County Hospital District Organization, Macomb, IL 5% Or Greater Direct Ownership Interest Jun 10, 2014 100%
Sherri L Hitchcock Individual Corporate OfficerCfo Feb 1, 2025
W-2 Managing EmployeeCfo Feb 1, 2025
William R Murdock Individual Corporate OfficerPresident & Ceo Apr 22, 2019
W-2 Managing EmployeePresident & Ceo Apr 22, 2019
Operational/Managerial ControlCfo Apr 22, 2019

Owners & managing parties with NPI records 10

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
McDonough District HospitalMacomb, IL, CCN 140089 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2018
McDonough District Hospital Home HealthMacomb, IL, CCN 147293 Home health agency Operational/Managerial Control (100%) Oct 22, 2012
McDonough District HospitalMacomb, IL, CCN 141524 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 12, 1989
Bushnell Family PracticeBushnell, IL, CCN 148522 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2013
MDH Family Medicine/Convenience Care/Surgery/ENT ClinicMacomb, IL, CCN 148619 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2020
MDH Pediatric ClinicMacomb, IL, CCN 148617 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2020

Owned or controlled facilities with NPI records 6

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

Affiliated clinicians 2

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": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1851705370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 E GRANT ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553313",
            "telephone_number": "309-833-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E GRANT ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553313",
            "telephone_number": "309-833-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-836-1675",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0001438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDonough District Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McDonough District Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macomb, IL

Sources for this page

Verify at the official NPI Registry.