Active NPI
Midwest Medical Center
- Critical Access Hospital
- Galena, IL
National Provider Identifier
1952409765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Access Hospital
- License
- 0005389
- Legal business name
- MIDWEST MEDICAL CENTER
- Practice address
- One Medical Center Drive
Galena, IL 61036-1635 - Phone
- (815) 776-7274
- NPI assigned
- Sep 20, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Tracy L Bauer
- Title
- Coo/Cfo
- Phone
- (815) 776-7277
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Access Hospital | 282NC0060X | 0005389 | IL | Primary |
Addresses
Primary practice location
One Medical Center Drive
Galena, IL 61036-1635
Mailing address
One Medical Center Drive
Galena, IL 61036-1635
Phone (815) 777-2560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14-8511 | Other | IL | MEDICARE ID FOR RURAL HEALTH CLINIC FROM DEPARTMENT OF HEALTH AND HUMAN SERVICE |
Other names 1
- Galena Stauss Hospital
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 6
Hospital certification: CCN 141302
- Legal name
- MIDWEST MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Feb 1, 2000
- Last certification
- Sep 28, 2023
- Beds
- 19
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- Jul 1, 2006 (1 total)
- Organization structure
- Corporation
- Incorporated
- Jul 1, 2008 in IL
- Enrollment address
- 1 Medical Center Dr
Galena, IL 61036-8118
Skilled nursing facility certification: CCN 146140
- Legal name
- MIDWEST MEDICAL CENTER
- Doing business as
- GALENA STAUSS NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Feb 17, 2010
- Last certification
- Oct 3, 2024
- Beds
- 57
- Ownership / control type
- Other Nonprofit
- Organization structure
- Other
- Incorporated
- Jul 1, 2008 in IL
- Enrollment address
- 215 Summit St
Galena, IL 61036-1635 - Nursing home name
- GALENA STAUSS NURSING HOME
Rural health clinic certification: CCN 148511
- Legal name
- MIDWEST MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Dec 9, 2010
- Last certification
- Apr 4, 2018
- Ownership / control type
- 2B
- Organization structure
- Other
- Incorporated
- Jul 1, 2008 in IL
- Enrollment address
- 1 Medical Center Dr
Galena, IL 61036-8118 - Related CCNs
- 141302
Rural health clinic certification: CCN 148557
- Legal name
- MIDWEST MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 15, 2016
- Last certification
- Jul 15, 2016
- Ownership / control type
- 2B
- Organization structure
- Other
- Incorporated
- Jul 1, 2008 in IL
- Enrollment address
- 117 N Main St
Elizabeth, IL 61028-8800 - Related CCNs
- 141302
Hospital certification: CCN 14Z302
- Legal name
- MIDWEST MEDICAL CENTER
- Organization structure
- Other
- Incorporated
- Jul 1, 2008 in IL
- Enrollment address
- 1 Medical Center Dr
Galena, IL 61036-8118
Related certifications (CCN) 2
Facilities connected through Provider of Services related, parent or unit certification numbers.
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare: Hospital
Medicare Care Compare- Listed as
- Midwest Medical Center
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Galena Stauss Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Feb 17, 2010
- Medicare certification status
- Active
- Certified beds
- 57
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryInteroperability endpoints
- drambousek@midwestmedicalcenter.cernerdirect.com
- mgullone@midwestmedicalcenter.cernerdirect.com
- midwestmedical@midwestmedicalcenter.cernerdirect.com
- mwells@midwestmedicalcenter.cernerdirect.com
- mdittmar@midwestmedicalcenter.cernerdirect.com
- egullone@midwestmedicalcenter.cernerdirect.com
- gharmston@midwestmedicalcenter.cernerdirect.com
- elizabethhealthclinic@midwestmedicalcenter.cernerdirect.com
- midwesthealthclinic@midwestmedicalcenter.cernerdirect.com
Ownership & related parties
All disclosed owners & managing parties 23
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Paul Carter Newton | Corporate Director | Jan 1, 2019 | |
| Katherine a Meusel | W-2 Managing Employee | Dec 14, 2015 | |
| W-2 Managing Employee | Oct 12, 2015 | ||
| Matthew Carroll | Corporate Director | Jan 1, 2019 | |
| Joel C Holland | Corporate Director | May 2, 2017 | |
| Donna Ferry | Corporate Director | Jan 1, 2019 | |
| John M Lorenzen | Corporate Director | May 2, 2017 | |
| Lynn Zehnder | Corporate Director | Jan 1, 2021 | |
| Barbara K Sloan | Corporate Director | May 2, 2017 | |
| Helen R Kilgore | Corporate Director | Jan 1, 2007 | |
| Tim Vincent | Corporate Director | Jan 1, 2022 | |
| Chris Curran | Corporate Director | Jan 1, 2022 | |
| Kelli Jackson | Corporate Officer | Aug 7, 2019 | |
| Tracy L Bauer | Corporate Officer | Apr 10, 2015 | |
| Corporate Officer | Sep 26, 2006 | ||
| W-2 Managing Employee | Sep 29, 2006 | ||
| Corporate Officer | Jan 26, 2009 | ||
| Corporate Director | Apr 16, 2007 | ||
| W-2 Managing Employee | Apr 16, 2007 | ||
| Corporate Officer | Apr 16, 2007 | ||
| Operational/Managerial Control | Apr 16, 2007 | ||
| Midwest Medical Foundation | 5% Or Greater Indirect Ownership Interest | Apr 25, 2019 | 100% |
| Marie a Wamsley | Corporate Officer | Apr 1, 2014 | |
| W-2 Managing Employee | Apr 1, 2014 | ||
| Corporate Officer | May 12, 2014 | ||
| W-2 Managing Employee | May 12, 2014 | ||
| David R. Hey | Corporate Director | Jan 1, 2013 | |
| Corporate Director | Jan 1, 2013 | ||
| Garry W Thompson | Corporate Director | Jan 1, 2014 | |
| Corporate Director | Dec 1, 2013 | ||
| Carol a Wrabl | Corporate Director | Jan 1, 2009 | |
| Corporate Director | Jan 1, 2008 | ||
| Vince E Toepfer | Corporate Director | Jan 1, 2009 | |
| Corporate Director | Jan 1, 2008 | ||
| Robert L. Miller | Corporate Director | Jan 1, 2009 | |
| Corporate Director | Jan 1, 2009 | ||
| Mary Sheahen | Corporate Director | Jan 1, 2012 | |
| Corporate Director | Apr 16, 2007 | ||
| Cheryl a. Farruggia | Corporate Director | Jan 1, 2008 | |
| William J. Morden | Corporate Director | Jan 1, 2006 |
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Rural Health Clinic/Center
- Elizabeth, IL
- NPI 1295286045
Midwest Medical Foundation
-
- Skilled Nursing Facility
- Galena, IL
- NPI 1487978227
Midwest Medical Foundation
Practitioners & affiliated clinicians
Practitioners 70
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medicine Physician
- Barrington, IL
- NPI 1952414682
-
- Family Nurse Practitioner
- Galena, IL
- NPI 1700308558
-
- Urology Physician
- Galena, IL
- NPI 1184638496
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1003865403
-
- Orthopaedic Surgery Physician
- Galena, IL
- NPI 1689652455
-
- Professional Counselor
- Galena, IL
- NPI 1285800318
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1316962798
-
- Family Nurse Practitioner
- Galena, IL
- NPI 1457188211
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1164447181
-
- Family Medicine Physician
- Galena, IL
- NPI 1679549877
-
- Psychiatric/Mental Health Nurse Practitioner
- Galena, IL
- NPI 1346714755
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1215324769
Affiliated clinicians 90
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": "1158710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1302825600000",
"number": "1952409765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE MEDICAL CENTER DRIVE",
"city": "GALENA",
"state": "IL",
"postal_code": "610361635",
"telephone_number": "815-777-2560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE MEDICAL CENTER DRIVE",
"city": "GALENA",
"state": "IL",
"postal_code": "610361635",
"telephone_number": "815-776-7274"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MIDWEST MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-20",
"last_updated": "2011-04-15",
"status": "A",
"authorized_official_last_name": "BAUER",
"authorized_official_first_name": "TRACY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "COO/CFO",
"authorized_official_telephone_number": "815-776-7277",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "282NC0060X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Critical Access",
"state": "IL",
"license": "0005389",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID FOR RURAL HEALTH CLINIC FROM DEPARTMENT OF HEALTH AND HUMAN SERVICE",
"identifier": "14-8511",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Galena Stauss Hospital",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Galena, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.