NPIMap

Organization Active NPI

Pana Community Hospital Association

  • Medicare Defined Swing Bed Hospital Unit
  • Pana, IL
National Provider Identifier
1962528802
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
0001776 Issued in IL
Legal business name
PANA COMMUNITY HOSPITAL ASSOCIATION
Practice address
101 E 9TH St
Pana, IL 62557-1716
Phone
(217) 562-2131
Fax
(217) 562-6271
NPI assigned
Mar 22, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Katrina J Casner
Title
Chief Financial Officer
Phone
(217) 562-2131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 0001776 IL Primary

Addresses

Primary practice location

101 E 9TH St
Pana, IL 62557-1716

Mailing address

101 E 9TH St
Pana, IL 62557-1716
Phone (217) 562-2131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080213000489 IL Part A Provider - Critical Access Hospital 3274437348 Practice locations: Pana, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962528802. Details of each certification follow.

Hospital certification: CCN 14Z341

Legal name
PANA COMMUNITY HOSPITAL ASSOCIATION
Doing business as
PANA COMMUNITY SWING BED
Organization structure
CorporationNon-profit
Incorporated
Feb 8, 1966 in IL
Enrollment address
101E 9TH St
Pana, IL 62557-1716
Other Hospital Practice Location

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

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Pana Community Hosp Assoc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

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
David Slater Individual Corporate Director May 1, 2017
James E Moon Individual Corporate OfficerCfo Jan 1, 2012
W-2 Managing EmployeeCfo Jan 1, 2012
Charles O'Malley Individual Corporate Director May 1, 2016
Frank McChristy Individual Corporate Director May 1, 2023
Jason Bauer Individual Corporate Director May 1, 2023
Brian Blodgett Individual Corporate Director May 1, 2023
Kenneth Flesch Individual Corporate Director May 1, 2017
David Dorn Individual Corporate Director May 1, 2023
Jimmie Brewer Individual Corporate Director May 1, 2016
Katrina J Casner Individual Corporate OfficerPresident & Ceo Jan 1, 2012
W-2 Managing EmployeePresident & Ceo Jan 28, 2008
Dianne M Bailey Individual W-2 Managing EmployeeCio Jul 1, 2015
Roy Goff Individual Corporate Director May 1, 2023
Patrick McGuire Individual W-2 Managing EmployeeCne/Cco Feb 28, 2023
Walter H Cunnington Individual Corporate Director May 1, 2015

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Community Medical Clinic of NokomisNokomis, IL, CCN 148574 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Dec 1, 2016
Jul 19, 2022
Community Medical Clinic of AssumptionAssumption, IL, CCN 148575 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Dec 1, 2016
Jul 19, 2022
Cowden Medical GroupCowden, IL, CCN 148637 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Aug 1, 2022
Aug 1, 2022

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1962528802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E 9TH ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571716",
            "telephone_number": "217-562-2131",
            "fax_number": "217-562-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 9TH ST",
            "city": "PANA",
            "state": "IL",
            "postal_code": "625571716",
            "telephone_number": "217-562-2131",
            "fax_number": "217-562-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANA COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CASNER",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "217-562-2131"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "IL",
            "license": "0001776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pana, IL

Sources for this page

Verify at the official NPI Registry.