NPIMap

Organization Active NPI

McDonough County Hospital District

  • General Acute Care Hospital
  • Macomb, IL
National Provider Identifier
1891024584
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
0001438 Issued in IL
Legal business name
MCDONOUGH COUNTY HOSPITAL DISTRICT
Practice address
505 E Grant St
Suite 306
Macomb, IL 61455-3352
Phone
(309) 836-6400
Fax
(309) 836-5001
NPI assigned
Dec 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Authorized official

Name
Mr. Stephen R Hopper
Title
Ceo
Phone
(309) 833-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 0001438 IL Primary

Addresses

Primary practice location

505 E Grant St
Suite 306
Macomb, IL 61455-3352

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0005519706OtherILBLUE CROSS

Other names 1

  • McDonough District Hospital Psychiatry Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090407000082 IL Part B Supplier - Clinic/Group Practice 0446140180 Receives reassigned benefits from 78 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monmouth, IL; Macomb, IL; Carthage, IL

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

505 E Grant St
Ste 306
Macomb, IL 61455
Phone (309) 836-1730

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1891024584",
    "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",
            "fax_number": "309-836-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E GRANT ST",
            "address_2": "SUITE 306",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614553352",
            "telephone_number": "309-836-6400",
            "fax_number": "309-836-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "HOPPER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "309-833-4101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "0001438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0005519706",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDonough District Hospital Psychiatry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.