Pana Community Hospital Association
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Pana, IL
NPI 1962528802 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1962528802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 0001776 (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
- Organization subpart
- No
Authorized official
- Name
- Katrina J Casner
- Title
- Chief Financial Officer
- Phone
- (217) 562-2131
Owners & managing parties with NPI records 1
-
Walter H Cunnington III, M.D.
Owned or controlled facilities with NPI records 3
Other NPIs with the same Medicare PAC ID 9
Corporate family (same tax ID) 16
Related certifications (CCN) 1
Practitioners 55
-
Samaj Adhikari, MD
-
Kris Alloju, MD
-
Blair Nicole Angel, FNP
-
Debra L Anklam, APN
-
Allison Leanne Beyers, FNP-C
-
Mollie Rae Beyers, PT, DPT
-
Aaron Brewer, M.D.
-
Samantha Burton, LCSW
-
Piero Capecci, M.D.
-
Holly Marie Chapman, APN
-
Abigail Maciolek Cochran, M.D.
-
Kevin Collins, NP
-
Jamie Cross, MSN, NP-C
-
Walter H Cunnington III, M.D.
-
Richard T Eden, MD
-
Bryce Fortner, PT, DPT
-
Albert F Gilman IV, M.D.
-
Daryn Jordan Handlin, APRN
-
Saurabh Jha, M.D.
-
Stephanie L Kulavic, PA-C, ATC
Affiliated clinicians 9
-
Samaj Adhikari, MD
-
Jabari E Munroe, MD
-
Gaurang P Patel, MD
-
Ritika Sharma, M.D.
-
Anuj Kumar Singh, MD
-
Pratibha Singla, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Hospital certification: CCN 14Z341
- Legal name
- PANA COMMUNITY HOSPITAL ASSOCIATION
- Doing business as
- PANA COMMUNITY SWING BED
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 8, 1966 in IL
- Enrollment address
- 101E 9TH St
Pana, IL 62557-1716
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| David Slater |
Corporate Director | May 1, 2017 | |
| James E Moon |
Corporate Officer |
Jan 1, 2012 | |
| W-2 Managing Employee |
Jan 1, 2012 | ||
| Charles O'Malley |
Corporate Director | May 1, 2016 | |
| Frank McChristy |
Corporate Director | May 1, 2023 | |
| Jason Bauer |
Corporate Director | May 1, 2023 | |
| Brian Blodgett |
Corporate Director | May 1, 2023 | |
| Kenneth Flesch |
Corporate Director | May 1, 2017 | |
| David Dorn |
Corporate Director | May 1, 2023 | |
| Jimmie Brewer |
Corporate Director | May 1, 2016 | |
| Katrina J Casner |
Corporate Officer |
Jan 1, 2012 | |
| W-2 Managing Employee |
Jan 28, 2008 | ||
| Dianne M Bailey |
W-2 Managing Employee |
Jul 1, 2015 | |
| Roy Goff |
Corporate Director | May 1, 2023 | |
| Patrick McGuire |
W-2 Managing Employee |
Feb 28, 2023 | |
| Walter H Cunnington |
Corporate Director | May 1, 2015 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Community Medical Clinic of Nokomis |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control |
Dec 1, 2016 Jul 19, 2022 |
| Community Medical Clinic of Assumption |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Dec 1, 2016 Jul 19, 2022 |
| Cowden Medical Group |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Aug 1, 2022 Aug 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080213000489 | IL | Part a Provider - Critical Access Hospital | 3274437348 | Practice locations: Pana, IL |
National Provider Directory
- Tax ID family
- Pana Internal Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 0001776 | IL | Yes |
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
Other providers in Pana, IL
- Pana Community Hospital Association
- Pana Community Hospital Association
- Pana Community Hospital Association
- Pana Community Hospital Association
- Pana Community Hospital Association
- Pana Cusd 8
- Pana Health and Rehab Center LLC
- Pana Health and Rehab Center LLC
- Pana Medical Group
- Laura Pauley
All providers in Pana, IL · Medicare Defined Swing Bed Hospital Unit in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.