Gibson Community Hospital Association
Organization Active NPI Rural Health Clinic/Center · Onarga, IL
NPI 1972509701 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1972509701
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- GIBSON COMMUNITY HOSPITAL ASSOCIATION
- Practice address
- 912 W Seminary Ave
Onarga, IL 60955-1401 - Phone
- (815) 268-4840
- Fax
- (815) 268-4845
- NPI assigned
- Jun 27, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- GIBSON COMMUNITY HOSPITAL ASSOCIATION
Authorized official
- Name
- Matthew Ertel
- Title
- Chief Financial Officer
- Phone
- (217) 784-2601
Owners & managing parties with NPI records 4
-
David John Hagan, MD
-
Darrin Ray, MD
-
Donald Pearson Reese, M.D.
-
Mark M Spangler, MD
Other NPIs on the same Medicare enrollment 43
Other NPIs with the same Medicare PAC ID 15
Related certifications (CCN) 25
Practitioners 160
-
Lori Ann Knutstrom, D.P.M.
-
Cynthia-Lewis Lee, LCSW
-
Waheed Jalalzai, M.D.
-
Michael T Abaca, CRNA
-
Syed Akbar, MD
-
Kareem Alazem, MD
-
Laura Nicole Alexander, APRN FNP-BC
-
Bashar M Alzein, M.D.
-
Anas Alzoobi, MD
-
Neil J. Atkins, MPT
-
Leya M Barrett, LCSW
-
Patricia Belle, MD
-
Ismail Bobat, MD
-
Surekha Boddipalli, M.D.
-
Jesse Paul Butler, M.D.
-
Katie S Cafarelli, MSW, LCSW
-
Jennifer Casey, APN
-
Jason N Casteel, MSW, LCSW
-
Brandy Caywood, A.P.N.
Affiliated clinicians 153
-
Michael T Abaca, CRNA
-
Naveed A Adoni I, MD
-
Kareem Alazem, MD
-
Laura Nicole Alexander, APRN FNP-BC
-
Basil Ahmad Ali, MD
-
Bashar M Alzein, M.D.
-
Anas Alzoobi, MD
-
Robert A Bane, MD
-
Kenneth R Barba, M.D.
-
Patricia Belle, MD
-
Ismail Bobat, MD
-
Surekha Boddipalli, M.D.
-
Andrea Brasch, MD
-
Jesse Paul Butler, M.D.
-
Jennifer Casey, APN
-
Brandy Caywood, A.P.N.
-
Swathi Chalasani, MD
-
Sohail A Chaudhry, M.D.
-
Joseph Yo Chung, M.D.
Medicare Care Compare: Hospital
- Listed as
- Gibson Community Hospital
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Critical Access Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0927783 | Onarga Clinic,the | Provider-performed microscopy | Nov 26, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in IL
Hospital certification: CCN 141317
- Legal name
- GIBSON COMMUNITY HOSPITAL ASSOCIATION
- Doing business as
- GIBSON AREA HOSPITAL & HEALTH SERVICES
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 3, 2002
- Last certification
- Oct 7, 2016
- Beds
- 25
- Ownership / control type
- Private (not for profit)
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 30, 1946 in IL
- Enrollment address
- 1120 N Melvin St
Gibson City, IL 60936-1477
Rural health clinic certification: CCN 143440
- Legal name
- GIBSON COMMUNITY HOSPITAL ASSOCIATION
- Doing business as
- THE ONARGA CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Sep 5, 1997
- Last certification
- Mar 20, 2026
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 30, 1946 in IL
- Enrollment address
- 912 W Seminary Ave
Onarga, IL 60955-1401 - Related CCNs
- 141317
All disclosed owners & managing parties 24
| Name | Role | Since | Share |
|---|---|---|---|
| Robert C Schmitt |
Corporate Officer |
Dec 9, 2002 | |
| W-2 Managing Employee |
Dec 9, 2002 | ||
| Corporate Officer |
Dec 9, 2002 | 100% | |
| W-2 Managing Employee |
Dec 9, 2002 | 100% | |
| Jessica Delost |
Corporate Officer | Oct 1, 2022 | |
| W-2 Managing Employee | Oct 1, 2022 | ||
| Michael E Young |
Corporate Director | Nov 1, 2001 | |
| Corporate Director |
Nov 1, 2001 | ||
| Ellen M Lee |
Corporate Director | Nov 1, 1990 | |
| Corporate Director |
Nov 1, 1990 | ||
| Mark M Spangler |
Corporate Director | Nov 1, 2022 | |
| Justin Taylor |
Corporate Director | Mar 1, 2018 | |
| Corporate Director |
Mar 1, 2018 | ||
| Kevin D Seymour |
Corporate Director | Mar 1, 2018 | |
| Corporate Director |
Mar 1, 2018 | ||
| Kathleen J Bennett |
Corporate Director | Nov 1, 2010 | |
| Corporate Director |
Nov 1, 2010 | ||
| Donald P Reese |
Corporate Director | Feb 1, 2021 | |
| Matthew R Ertel |
Corporate Officer |
Oct 1, 2016 | |
| W-2 Managing Employee |
Oct 1, 2016 | ||
| Robin L Rose |
Corporate Officer |
Nov 15, 2004 | |
| W-2 Managing Employee |
Nov 15, 2004 | ||
| Corporate Officer |
Nov 15, 2004 | ||
| W-2 Managing Employee |
Nov 15, 2004 | ||
| Andy Hudson |
Corporate Officer | Nov 1, 2022 | |
| Marty a Nuss |
Corporate Director | Nov 1, 2010 | |
| Corporate Director |
Nov 1, 2010 | ||
| Steven P Kelly |
Corporate Director | Nov 1, 2009 | |
| Corporate Director |
Nov 1, 2009 | ||
| Brian E Steidinger |
Corporate Director | Nov 16, 2016 | |
| Corporate Director |
Nov 16, 2016 | ||
| Justin Swan |
Corporate Director | Oct 1, 2022 | |
| Mike E Petersen |
Corporate Director | Mar 1, 2018 | |
| Corporate Director |
Mar 1, 2018 | ||
| Margo C Martin |
Corporate Director | Nov 1, 1999 | |
| Corporate Director |
Nov 1, 1999 | ||
| Nancy L Krumwiede |
Corporate Director |
Nov 1, 1999 | |
| Grant W Kummerow |
W-2 Managing Employee |
Jan 8, 2018 | |
| Carl E Hudson |
Corporate Director |
Nov 1, 1988 | |
| David J Hagan |
Corporate Director |
Nov 1, 1985 | |
| W-2 Managing Employee |
Jun 1, 2016 | ||
| Teresa L Gardner |
W-2 Managing Employee |
Jan 17, 2020 | |
| Darrin M Ray |
Corporate Director |
Nov 16, 2016 | |
| W-2 Managing Employee |
Nov 16, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040505001293 | IL | Part B Supplier - Clinic/Group Practice | 5092703124 |
Receives reassigned benefits from 201 practitioners 38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Watseka, IL; Urbana, IL; Paxton, IL; Fairbury, IL; Onarga, IL; Mahomet, IL; Hoopeston, IL; Gibson City, IL… |
| O20071116000131 | IL | Part a Provider - Critical Access Hospital | 5092703124 |
Receives reassigned benefits from 156 practitioners 22 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Onarga, IL; Hoopeston, IL; Gibson City, IL; Forrest, IL; Cissna Park, IL |
| O20100812000754 | IL | Part a Provider - Rural Health Clinic | 5092703124 | Practice locations: Onarga, IL |
National Provider Directory
- Part of
- The Paxton Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Rural Health Clinic/Center | 261QR1300X | 007 | IL | |
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
912 W Seminary Ave
Onarga, IL 60955-1401
Mailing address
912 W Seminary Ave
Onarga, IL 60955-1401
Phone (815) 268-4840
Other names
- The Onarga Clinic
Other providers in Onarga, IL
- Shelby Clubb
- E David Noh PC
- Katherine M Fox
- Gibson Community Hospital Association
- Beth Gomez
- Susan Kay Gray
- Iroqouois Mental Health Center
- Iroquois Mental Health Center
- Lori Ann Knutstrom
All providers in Onarga, IL · Rural Health Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.