NPIMap

Organization Active NPI

Union Hospital Inc

Doing business as Cork Medical Center

  • Rural Health Clinic/Center
  • Marshall, IL
National Provider Identifier
1952335192
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
UNION HOSPITAL INC
Doing business as
Cork Medical Center
Practice address
408 N 2ND St
Marshall, IL 62441-1010
Phone
(217) 826-2361
Fax
(217) 826-2366
NPI assigned
Jul 11, 2006
Last updated
Jul 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
UNION HOSPITAL INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Steve Holman
Title
Ceo
Phone
(812) 238-7606

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

408 N 2ND St
Marshall, IL 62441-1010

Mailing address

PO Box 2505
Indianapolis, IN 46206-2505
Phone (812) 238-7783

Other identifiers 3

IdentifierTypeStateIssuer
200074840JMedicaidIN
148987OtherILRIVERBEND
CH2578OtherILRR MEDICARE

Other names 1

  • Cork Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040217000654 IL Part B Supplier - Clinic/Group Practice 8426943614 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Marshall, IL; Paris, IL
O20051115001196 IL Part A Provider - Rural Health Clinic 8426943614 Practice locations: Marshall, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952335192. Details of each certification follow.

Rural health clinic certification: CCN 148987

Legal name
UNION HOSPITAL INC
Doing business as
CORK MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 10, 2006
Last certification
Feb 26, 2026
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 6, 1895 in IN
Enrollment address
408N 2ND St
Marshall, IL 62441-1010

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 1

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

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
14D1014582Cork Medical Center408 N 2ND St, Marshall, IL 62441Provider-performed microscopyJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Janis C Ingebrigtsen MD29 organizations share this tax ID, including this one
Part of
Janis C Ingebrigtsen MD

Other organizations with this tax ID 28

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

View all 28

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
John Aidoo Individual Corporate DirectorBoard Member Jan 1, 2021
Mary Doti Individual Corporate DirectorBoard Member Jan 1, 2018
Tim Sullivan Individual Corporate DirectorBoard Member Jan 1, 2021
Robert a Coons Individual Corporate OfficerVice Chairman Jan 1, 2021
Corporate DirectorBoard Member Oct 23, 2014
John C Etling Individual Corporate DirectorBoard Member Jan 1, 2019
Kenneth M Kigorwe Individual OtherBoard Member Jan 1, 2023
Luke Terry Individual Corporate OfficerTreasurer Jan 1, 2022
Corporate DirectorBoard Member Jan 1, 2021
Kathleen D Coutinho Individual Corporate DirectorBoard Member Jan 1, 2019
Donald T Scott Individual Corporate OfficerChairman Jan 1, 2021
Corporate DirectorBoard Member Oct 23, 2014
Steven M Holman Individual Corporate OfficerPresident and Ceo Apr 30, 2014
W-2 Managing EmployeePresident and Ceo Apr 30, 2014
Richard Templeton Individual OtherBoard Member Jan 1, 2024
Sara D Smith Individual Corporate OfficerSecretary Jan 1, 2021
Corporate DirectorBoard Member Oct 23, 2014
Molly a Callahan Individual Corporate DirectorBoard Member Oct 1, 2005
Union Hospital Inc Organization, Terre Haute, IN Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2001 100%

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Union Hospital ClintonClinton, IN, CCN 151326 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 27, 2005
Union Hospital IncTerre Haute, IN, CCN 150023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Union Hospital Medical Rehabilitation UnitTerre Haute, IN, CCN 15T023 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 1989
Union Hospital ClintonClinton, IN, CCN 15Z326 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 27, 2005
Union Hospital IncTerre Haute, IN, CCN 15S023 Hospital 5% Or Greater Indirect Ownership Interest Jan 1, 1966
Clay City Center for Family MedicineClay City, IN, CCN 153804 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 10, 1993
Brazil Family MedicineBrazil, IN, CCN 153869 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Sep 30, 2016

Owned or controlled facilities with NPI records 9

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

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 10

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1952335192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2505",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062505",
            "telephone_number": "812-238-7783",
            "fax_number": "812-238-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N 2ND ST",
            "city": "MARSHALL",
            "state": "IL",
            "postal_code": "624411010",
            "telephone_number": "217-826-2361",
            "fax_number": "217-826-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNION HOSPITAL INCORPORATED",
        "enumeration_date": "2006-07-11",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-238-7606"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200074840J",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIVERBEND",
            "identifier": "148987",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH2578",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cork Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cork Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshall, IL

Sources for this page

Verify at the official NPI Registry.