NPIMap

Organization Active NPI

Hamilton Memorial Hospital District

  • Critical Access Hospital
  • McLeansboro, IL
National Provider Identifier
1881890028
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
0000885 Issued in IL
Legal business name
HAMILTON MEMORIAL HOSPITAL DISTRICT
Practice address
611 S Marshall Ave
MC Leansboro, IL 62859-1213
Phone
(618) 643-2361
Fax
(618) 643-2502
NPI assigned
Jun 25, 2007
Last updated
Aug 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Mr. Justin Epperson
Title
Cfo
Phone
(618) 643-2361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0000885 IL Primary

Addresses

Primary practice location

611 S Marshall Ave
MC Leansboro, IL 62859-1213

Mailing address

PO Box 429
MC Leansboro, IL 62859-0429
Phone (618) 643-2361

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070524000241 IL Part A Provider - Critical Access Hospital 6608865985 Practice locations: MC Leansboro, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881890028. Details of each certification follow.

Hospital certification: CCN 14Z326

Legal name
HAMILTON MEMORIAL HOSPITAL DISTRICT
Organization structure
OtherNon-profit
Enrollment address
611 S Marshall Ave
MC Leansboro, IL 62859-1213
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Cope Asuncion MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kenny Aydt Individual Corporate DirectorBoard Member Jan 1, 2023
Greg Muehlenbein Individual Corporate Director Jul 10, 2008
John Warner Individual Corporate DirectorBoard Member Jan 1, 2023
Marilyn Cross Individual Corporate DirectorBoard Member Jan 1, 2023
Paula J Hatfield Individual Corporate Director Jul 31, 2011
Justin Epperson Individual Corporate OfficerCfo Jul 1, 2020
Corporate DirectorCfo Jul 1, 2020
W-2 Managing EmployeeCfo Jul 1, 2020
Jason Waier Individual Corporate DirectorBoard Member Jan 1, 2023
Wayne Morris Individual Corporate Director Aug 31, 2011
Kelly Karcher Individual Corporate DirectorBoard Member Jan 1, 2023

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Hamilton Memorial Family ClinicCarmi, IL, CCN 148529 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2012

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1881890028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628590429",
            "telephone_number": "618-643-2361",
            "fax_number": "618-643-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 S MARSHALL AVE",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591213",
            "telephone_number": "618-643-2361",
            "fax_number": "618-643-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON MEMORIAL HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "EPPERSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "618-643-2361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "IL",
            "license": "0000885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLeansboro, IL

Sources for this page

Verify at the official NPI Registry.