KATHERINE SHAW BETHEA HOSPITAL (NPI# 1023003720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023003720 |
| Entity Type | Organization |
| Organization Name | KATHERINE SHAW BETHEA HOSPITAL |
| Practice Address |
403 E 1st St Dixon IL 61021-3116 |
| Practice Telephone | 8152885531 |
| Mailing Telephone | 8152885531 |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. VERNON FARRELL (VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 8152855511 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 0000497 | IL | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043546 | Katherine Shaw Bethea Hospital | General Acute Care Hospital | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-14 |
| 1912404765 | Katherine Shaw Bethea Hospital | Medicare Defined Swing Bed Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2018-04-09 |
| 1497281620 | Katherine Shaw Bethea Hospital | Pharmacy | 403 E 1st St, Dixon, IL 61021-3116 | 2017-05-09 |
| 1962600072 | Katherine Shaw Bethea Hospital | Medicare Defined Swing Bed Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2007-07-10 |
| 1205031721 | Katherine Shaw Bethea Hospital | Hospice Care, Community Based | 101 W 2nd St, Suite 203, Dixon, IL 61021-3076 | 2007-06-15 |
| 1811987134 | Katherine Shaw Bethea Hospital | Home Health | 101 W 2nd St, Suite 203, Dixon, IL 61021-3076 | 2005-10-27 |
| 1770578395 | Katherine Shaw Bethea Hospital | Personal Emergency Response Attendant | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-20 |
| Street Address |
403 E 1ST ST |
| City | DIXON |
| State | IL |
| Zip Code | 61021-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043546 | Katherine Shaw Bethea Hospital | General Acute Care Hospital | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-14 |
| 1063029247 | Valarie Pfoutz | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-30 |
| 1639786288 | Stephanie Marie Berlin | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-28 |
| 1639786270 | Marissa Leigh Frost | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-28 |
| 1588270797 | Tiffany L Hummel | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-22 |
| 1811513641 | Beth Barbara Reittinger | Podiatrist | 403 E 1st St, Dixon, IL 61021-3116 | 2020-06-17 |
| 1205458528 | Andres David Arellano | Physical Therapist | 403 E 1st St, Dixon, IL 61021-3116 | 2020-05-08 |
| 1144856667 | Connor Skoumal | Physical Therapist | 403 E 1st St, Dixon, IL 61021-3116 | 2020-03-16 |
| 1760022180 | Chris A Herbert | Emergency Medicine | 403 E 1st St, Dixon, IL 61021-3187 | 2020-01-14 |
| 1508414756 | Ann C Lee | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2019-08-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1740570316 | Robert Young Center | Psychiatric Unit | 4200 6th Ave, Rock Island, IL 61201-2109 | 2011-04-15 |
| 1669704326 | Isaac Ray Center At Cermak | Psychiatric Unit | 3159 N Seminary #301, Chicago, IL 60657 | 2010-02-05 |
| 1316115223 | 394567 D North | Psychiatric Unit | 4200 North Oak Park Ave, Chicago, IL 60634-1417 | 2008-02-13 |
| 1508034414 | 395061 Med Eval | Psychiatric Unit | 4200 North Oak Park Avenue, Chicago, IL 60634-1417 | 2008-02-13 |
| 1952425076 | Elgin Mental Health Center William White 4585 | Psychiatric Unit | 750 S. State St., Elgin, IL 60123-7692 | 2007-03-16 |
| 1932251766 | Families and Adolescents In Recovery, Inc. | Psychiatric Unit | 2010 E Algonquin Rd, Suite # 203-207, Schaumburg, IL 60173-4185 | 2007-01-18 |
| 1003976713 | Presence Central and Suburban Hospitals Network | Psychiatric Unit | 333 N. Madison St., Joliet, IL 60435-6595 | 2006-12-11 |
| 1871678334 | Kindred Thc Chicago, LLC | Psychiatric Unit | 2544 W Montrose Ave, Chicago, IL 60618 | 2006-10-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.