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Organization Active NPI

St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  • Rehabilitation Hospital Unit
  • Decatur, IL
National Provider Identifier
1891961371
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Practice address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone
(217) 464-2966
Fax
(217) 464-1609
NPI assigned
May 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mark D Evard
Title
VP of Revenue Cycle
Phone
(217) 492-9651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

1800 E Lake Shore Dr
Decatur, IL 62521-3810

Mailing address

3051 Hollis Dr
Springfield, IL 62704-7450
Phone (217) 464-2966

Other names 1

  • St. Marys Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address st_marys_decatur_toc2202619@ewd.direct.hshs.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080724000388 IL Part A Provider - Hospital 6608767181 Practice locations: Decatur, IL

Hospital certification: CCN 14T166

Legal name
ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Doing business as
ST. MARY'S HOSPITAL- DECATUR
Organization structure
CorporationNon-profit
Enrollment address
1800 E Lake Shore Dr
Decatur, IL 62521-3810
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
St Marys HospitalCCN 14T166
Ownership
Non-profit
Certified
Jul 1, 2008

National Provider Directory

National Provider Directory
Tax ID family
St Amrys Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
James Z Schwarz Individual Corporate DirectorBoard Member May 1, 2022
M, Rasheed Orakzai Individual Corporate DirectorBoard Member May 1, 2026
Jeffery Sterling Individual Corporate DirectorVice President- Managed Care Jun 1, 2025
W-2 Managing EmployeeVice President- Managed Care Jun 1, 2025
Rick Weltin Individual Corporate DirectorBoard Member Nov 1, 2017
Debbie Bogle Individual Corporate DirectorBoard Member Jun 1, 2025
Timothy Layman Individual Corporate DirectorPresident & Ceo May 1, 2026
Trudy O'Connor Individual Corporate DirectorBoard Member May 1, 2022
Hospital Sisters Services Inc Organization, Springfield, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Julie Brilley Individual Corporate DirectorBoard Member May 1, 2026
Dale Colee Individual Corporate DirectorVice Chairperson May 1, 2026
Michael Breheny Individual Corporate DirectorBoard Member May 1, 2026
Drew Hickey Individual Corporate DirectorBoard Member Jan 1, 2024
Allison Matusin Individual Corporate DirectorChairperson May 1, 2026
Paige Toth Individual Corporate DirectorSecretary Oct 29, 2025
Ann Bond Individual Corporate DirectorSystem Director Oct 29, 2025
W-2 Managing EmployeeSystem Director-Government Reimburs Oct 29, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1891961371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 HOLLIS DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047450",
            "telephone_number": "217-464-2966",
            "fax_number": "217-464-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E LAKE SHORE DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213810",
            "telephone_number": "217-464-2966",
            "fax_number": "217-464-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "EVARD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "217-492-9651"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "st_marys_decatur_toc2202619@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1800 E Lake Shore Dr",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625213810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St. Marys Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St. Marys Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.