CASEY HCO, LLC (NPI# 1093771800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093771800 |
| Entity Type | Organization |
| Organization Name | CASEY HCO, LLC |
| Other Organization Name | CASEY HEALTH CARE CENTER |
| Practice Address |
100 Ne 15th St Casey IL 62420-2152 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 2179325217 |
| Practice Fax Number | 2179325408 |
| Mailing Telephone | 3096918113 |
| Mailing Fax Number | 3096918622 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-09-15 |
| Authorized Official Name | MARK B. PETERSEN (MANAGER) |
| Authorized Official Telephone | 3096895880 |
| Is Organization Subpart | Y |
| Parent Organization Name | PETERSEN HEALTH CARE II, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 74-3055934007 | 05 |
| Other Name | Type Code |
|---|---|
| Casey Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275166423 | Casey Hco, LLC | Skilled Nursing Facility | 100 Ne 15th St, Casey, IL 62420-2152 | 2020-02-17 |
| Street Address |
100 NE 15TH ST |
| City | CASEY |
| State | IL |
| Zip Code | 62420-2152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275166423 | Casey Hco, LLC | Skilled Nursing Facility | 100 Ne 15th St, Casey, IL 62420-2152 | 2020-02-17 |
| 1902322076 | Makenzie Alicen Goble | Speech-Language Pathologist | 100 Ne 15th St, Casey, IL 62420-2152 | 2017-08-20 |
| 1124358064 | Katie Norman | Occupational Therapy Assistant | 100 Ne 15th St, Casey, IL 62420-2152 | 2009-12-26 |
| 1174768378 | Gena Cochonour | Physical Therapy Assistant | 100 Ne 15th St, Casey, IL 62420-2152 | 2008-12-03 |
| 1033364146 | Linda Mason | Physical Therapy Assistant | 100 Ne 15th St, Casey, IL 62420-2152 | 2008-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322296 | Champion Fitness, Inc | Clinic/Center | 1300 E. Us Highway 40, Casey, IL 62420 | 2016-09-01 |
| 1801089263 | Cory D Hanley | Physical Therapist | 1300 E Us Highway 40, Casey, IL 62420 | 2007-08-20 |
| 1528186665 | Sarah Bush Lincoln Health Center | Clinic/Center | 934 North Route 49, Casey, IL 62420 | 2007-03-27 |
| 1861499006 | Heartland Manor Inc Nursing Center | Skilled Nursing Facility | 410 N W Third Street, Casey, IL 62420 | 2005-07-01 |
| 1386124675 | Daniel Yi-li Wen | Dentist | 1400 E Main St, Casey, IL 62420 | 2018-08-16 |
| 1831228600 | Patrick M Niebrugge | Optometrist | 1279 E Us Hwy 40, Casey, IL 62420-0528 | 2007-03-05 |
| 1962696617 | Patrick Niebrugge Od | Durable Medical Equipment & Medical Supplies | 1279 E Us Hwy 40, Casey, IL 62420-0528 | 2007-09-05 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| 1891787529 | Robert Lee Dougherty | Physician Assistant | 412 Nw 3rd St, Casey, IL 62420-1014 | 2005-08-18 |
| 1952874075 | Scott E Stout | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| Find all providers in zip 62420 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| 1861499006 | Heartland Manor Inc Nursing Center | Skilled Nursing Facility | 410 N W Third Street, Casey, IL 62420 | 2005-07-01 |
| 1275166423 | Casey Hco, LLC | Skilled Nursing Facility | 100 Ne 15th St, Casey, IL 62420-2152 | 2020-02-17 |
| 1952874075 | Scott E Stout | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
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| 1114550381 | Rosiclare Hco, LLC | Skilled Nursing Facility | 55 Ferrell Rd, Rosiclare, IL 62982-1006 | 2020-02-17 |
| 1225672033 | All Ways Caring Services, Inc. | Skilled Nursing Facility | 301 N Neil St Ste 301, Champaign, IL 61820-3167 | 2019-11-05 |
| 1134696966 | Naperville Manor Hrc LLC | Skilled Nursing Facility | 200 Martin Ave, Naperville, IL 60540-6516 | 2018-10-30 |
| Find all providers with the same taxonomy | ||||
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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.