PETERSEN HEALTH CARE, INC (NPI# 1215188487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215188487 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH CARE, INC |
| Other Organization Name | KEWANEE CARE HOME |
| Practice Address |
144 Jounior Ave. Kewanee IL 61443 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 6188337093 |
| Mailing Telephone | 3096918113 |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |
| Authorized Official Name | MARK PETERSEN (PRESIDENT) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 0026518 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Kewanee Care Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073764213 | Petersen Health Care, Inc | Skilled Nursing Facility | 422 E 4th St S, Arcola, IL 61910-2059 | 2008-10-07 |
| 1609027846 | Petersen Health Care, Inc | Skilled Nursing Facility | 100 Eastview Pl, Sullivan, IL 61951-1674 | 2008-10-07 |
| 1265683429 | Petersen Health Care, Inc | Skilled Nursing Facility | 601 N Morgan St, Bement, IL 61813-1046 | 2008-10-07 |
| Street Address |
144 JOUNIOR AVE. |
| City | KEWANEE |
| State | IL |
| Zip Code | 61443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013453471 | Kelly Neirynck | Licensed Practical Nurse | 420 E Mill St, Kewanee, IL 61443 | 2017-01-10 |
| 1275760456 | Daniel P. Congreve | Surgery | 1051 West South Street, Kewanee, IL 61443 | 2009-06-16 |
| 1114112265 | Carla Greby | Internal Medicine | 2021 Kentville Rd, Iyc Kewanee, Kewanee, IL 61443 | 2007-09-12 |
| 1740362979 | Petersen Health Systems, Inc | Assisted Living Facility | 808 Sunset Drive, Kewanee, IL 61443 | 2006-10-19 |
| 1902993652 | Kerry Howard Head | Optometrist | 730 Tenney Street, Kewanee, IL 61443 | 2006-10-06 |
| 1205927464 | Gordon M Pointer | Chiropractor | 627 East 2nd St, Kewanee, IL 61443 | 2006-09-27 |
| 1699887729 | Stephen L Rider | Dentist | 125 West South Street, Suite #10, Kewanee, IL 61443 | 2006-08-31 |
| 1336153121 | Kelli E Rashid | Occupational Therapist | 125 South Street, Suite B, Kewanee, IL 61443 | 2006-07-28 |
| 1740247394 | Jon A Debord | Physical Therapist | 125 South St, Suite B, Kewanne, IL 61443 | 2006-04-27 |
| 1174583678 | Dennis J Gerleman | Chiropractor | 320 Tenney St, Kewanee, IL 61443 | 2006-03-27 |
| Find all providers in zip 61443 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386094068 | Icg Home Health | Nursing Facility/Intermediate Care Facility | 4508 Camden Ct, Richton Park, IL 60471-1147 | 2016-06-14 |
| 1871999078 | Midwest Health Operations LLC | Nursing Facility/Intermediate Care Facility | 3601 16th Ave, Sterling, IL 61081-4059 | 2014-11-15 |
| 1437410891 | Mado Healthcare | Nursing Facility/Intermediate Care Facility | 1541 North Wells, Chicago, IL 60610-1307 | 2012-06-01 |
| 1134405392 | Faith Community Health Services, Inc | Nursing Facility/Intermediate Care Facility | 4449 177th St, Country Club Hills, IL 60478-4705 | 2011-11-01 |
| 1699936054 | Pinckneyville Healthcare Center | Nursing Facility/Intermediate Care Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2008-06-18 |
| 1184894412 | Parents and Friends of The Slc-home 1 | Nursing Facility/Intermediate Care Facility | 3 Gundlach Pl, Swansea, IL 62226-4227 | 2008-03-03 |
| 1740463074 | St. Joseph's Home of Springfield | Nursing Facility/Intermediate Care Facility | 3306 S 6th Street Rd, Springfield, IL 62703-4735 | 2007-12-10 |
| 1821283573 | Royal Living Center Inc | Nursing Facility/Intermediate Care Facility | 200 South 9th Street, New Baden, IL 62265 | 2007-09-06 |
| 1235323841 | Parents and Friends of Slc | Nursing Facility/Intermediate Care Facility | 1450 Caseyville Ave, Swansea, IL 62226-4517 | 2007-08-28 |
| 1629276225 | Elizabeth Nursing Home Corp | Nursing Facility/Intermediate Care Facility | 540 Pleasant St, Elizabeth, IL 61028-9508 | 2007-07-05 |
| 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.