NPIMap

Organization Active NPI

Thomas H. Boyd Memorial Hospital

Doing business as Boyd Fillager Clinic

  • Rural Health Clinic/Center
  • Greenfield, IL
National Provider Identifier
1912090960
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
THOMAS H. BOYD MEMORIAL HOSPITAL
Doing business as
Boyd Fillager Clinic
Practice address
712 College St
Greenfield, IL 62044-1409
Phone
(217) 368-3051
Fax
(217) 368-2213
NPI assigned
Oct 2, 2006
Last updated
Apr 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Stace Holland
Title
Ceo
Phone
(217) 942-6946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

712 College St
Greenfield, IL 62044-1409

Mailing address

712 College St
Greenfield, IL 62044-1409
Phone (217) 368-3051

Other names 1

  • Boyd Fillager Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080114000062 IL Part A Provider - Rural Health Clinic 8123085560 Practice locations: Greenfield, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912090960. Details of each certification follow.

Rural health clinic certification: CCN 143474

Legal name
THOMAS H BOYD MEMORIAL HOSPITAL
Doing business as
BOYD-FILLAGER CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 4, 2005
Last certification
Oct 8, 2024
Ownership / control type
2A
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1941 in IL
Enrollment address
712 College St
Greenfield, IL 62044-1409
Related CCNs
141300

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

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0433641Thomas H Boyd Memorial Hospital712 S College, Greenfield, IL 62044Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Boyd Mem Hosp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Jenny Clough Individual Corporate DirectorBoard of Trustees Oct 1, 2022
Raymond Beavers Individual Corporate Director Feb 1, 2016
Kathryn Garner Individual Corporate OfficerCfo Nov 19, 2022
W-2 Managing EmployeeCfo Nov 19, 2022
Mary Tunison Individual Corporate Director Jun 17, 2002
Diane Wolfley Individual Corporate Director Dec 1, 2004
Stacy D Holland Individual Corporate OfficerCeo Apr 22, 2024
W-2 Managing EmployeeAd; Apr 22, 2024
Mary Plummer Individual Corporate DirectorBoard of Trustees Dec 1, 2018
Kirby Ballard Individual Corporate Director Sep 25, 2017

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Greene County Rural Health ClinicCarrollton, IL, CCN 143403 Rural health clinic Operational/Managerial Control Jun 21, 2010

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1912090960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 COLLEGE ST",
            "city": "GREENFIELD",
            "state": "IL",
            "postal_code": "620441409",
            "telephone_number": "217-368-3051",
            "fax_number": "217-368-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 COLLEGE ST",
            "city": "GREENFIELD",
            "state": "IL",
            "postal_code": "620441409",
            "telephone_number": "217-368-3051",
            "fax_number": "217-368-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS H. BOYD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "STACE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-942-6946"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boyd Fillager Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenfield, IL

Sources for this page

Verify at the official NPI Registry.