NPIMap

Organization Active NPI

Bond County Treasurer

  • Community Based Hospice Care Agency
  • Greenville, IL
National Provider Identifier
1881779494
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BOND COUNTY TREASURER
Practice address
1520 S 4TH St
Greenville, IL 62246-2618
Phone
(618) 664-5020
Fax
(618) 664-9682
NPI assigned
Oct 25, 2006
Last updated
Jan 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Authorized official

Name
Tara Walter
Title
Billing Specialist
Phone
(618) 664-5020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X IL Primary

Addresses

Primary practice location

1520 S 4TH St
Greenville, IL 62246-2618

Mailing address

1520 S 4TH St
Greenville, IL 62246-2618
Phone (618) 664-5020

Other names 1

  • Bond County Health Department Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091026000227 IL Part A Provider - Hospice 0446355820 Practice locations: Greenville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881779494. Details of each certification follow.

Hospice certification: CCN 141594

Legal name
BOND COUNTY TREASURER
Doing business as
BOND COUNTY HEALTH DEPARTMENT
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 3, 1998
Last certification
Aug 11, 2021
Ownership / control type
Government - County
Organization structure
GovernmentNon-profit
Incorporated
Jul 1, 1966 in IL
Enrollment address
1520 South Fourth Street
Greenville, IL 62246-2618

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Bond County Health DepartmentCCN 141594 · All quality measures
Ownership
Government
Certified
Apr 3, 1998
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Bond County9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Bond County Treasurer Organization, Greenville, IL Operational/Managerial Control May 1, 1998 100%
John K Dawdy Individual Contracted Managing EmployeeMD; May 9, 2022
Sean P Eifert Individual Corporate OfficerAdministrator Jul 27, 2017
Operational/Managerial ControlAdministrator Feb 7, 2017
Brian Goodiel Individual Corporate DirectorHome Health and Hospice Director Oct 28, 2019

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Bond County Health DepartmentGreenville, IL, CCN 147023 Home health agency Operational/Managerial Control (100%) Jul 1, 1966

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1881779494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S 4TH ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462618",
            "telephone_number": "618-664-5020",
            "fax_number": "618-664-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S 4TH ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622462618",
            "telephone_number": "618-664-5020",
            "fax_number": "618-664-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOND COUNTY TREASURER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "618-664-5020"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bond County Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, IL

Sources for this page

Verify at the official NPI Registry.