NPIMap

Organization Active NPI

Morrison Community Hospital District

Doing business as Morrison Community Hospital Erie Clinic

  • Rural Health Clinic/Center
  • Erie, IL
National Provider Identifier
1992497168
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MORRISON COMMUNITY HOSPITAL DISTRICT
Doing business as
Morrison Community Hospital Erie Clinic
Practice address
530 12TH St
Erie, IL 61250-9461
Phone
(309) 659-2215
NPI assigned
May 24, 2023
Last updated
May 25, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MORRISON COMMUNITY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Pam Pfister
Title
Ceo
Phone
(815) 772-5530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

530 12TH St
Erie, IL 61250-9461

Mailing address

303 N Jackson St
Morrison, IL 61270-3042

Other names 1

  • Morrison Community Hospital Erie Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230724002453 IL Part A Provider - Rural Health Clinic 2466349907 Practice locations: Erie, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992497168. Details of each certification follow.

Rural health clinic certification: CCN 148657

Legal name
MORRISON COMMUNITY HOSPITAL DISTRICT
Doing business as
MORRISON COMMUNITY HOSPITAL ERIE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jun 30, 2023
Last certification
Nov 20, 2018
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
530 12TH St
Erie, IL 61250-9461
Related CCNs
141329

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

Other NPIs with the same Medicare PAC ID 5

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

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
14D0884681Morrison Community Hospital - Erie Clinic530 12TH Street, Erie, IL 61250Certificate of waiverJul 9, 2027

National Provider Directory

National Provider Directory
Tax ID family
Morrison Comm Hospital6 organizations share this tax ID, including this one
Part of
Morrison Comm Hospital

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Pamela J. Pfister Individual W-2 Managing EmployeeChief Executive Officer Jun 30, 2023
Operational/Managerial ControlChief Executive Officer Jun 30, 2023
Morrison Community Hospital District Organization, Morrison, IL Non-profit 5% Or Greater Direct Ownership Interest Jun 30, 2023 100%
Cami L Megli Individual W-2 Managing EmployeeCfo Jun 30, 2023
Operational/Managerial ControlCfo Jun 30, 2023

Owners & managing parties with NPI records 5

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
Morrison Community Hospital DistrictMorrison, IL, CCN 141329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Morrison Community Hospital DistrictMorrison, IL, CCN 14Z329 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Morrison Community Hospital DistrictMorrison, IL, CCN 143981 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Change-of-ownership history 1

DateEventCounterparty
Jun 30, 2023 Change of OwnershipThis provider was the buyer Genesis Rural Health CenterCCN 148918, IL, NPI 1023124831

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1992497168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N JACKSON ST",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612703042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 12TH ST",
            "city": "ERIE",
            "state": "IL",
            "postal_code": "612509461",
            "telephone_number": "309-659-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORRISON COMMUNITY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MORRISON COMMUNITY HOSPITAL DISTRICT",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "PFISTER",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-772-5530"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morrison Community Hospital Erie Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, IL

Sources for this page

Verify at the official NPI Registry.