HERITAGE MANOR BLOOMINGTON, LLC (NPI# 1457343170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457343170 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR BLOOMINGTON, LLC |
| Other Organization Name | HERITAGE HEALTH - BLOOMINGTON |
| Practice Address |
700 E Walnut St Bloomington IL 61701-3244 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 3098278004 |
| Practice Fax Number | 3098270256 |
| Mailing Telephone | 3098284361 |
| Mailing Fax Number | 3098295477 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | DAVID M UNDERWOOD (SR. VP & CFO) |
| Authorized Official Telephone | 3098284361 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE ENTERPRISES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 224Z00000X | Occupational Therapy Assistant | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 225XP0019X |
Occupational Therapist Specialization: Physical Rehabilitation |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 225200000X | Physical Therapy Assistant | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 235Z00000X | Speech-Language Pathologist | IL | Speech, Language and Hearing Service Providers | |
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
48157 | IL | Suppliers |
| Y | 314000000X | Skilled Nursing Facility | 48157 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Health - Bloomington | Doing Business As Name - Organization |
| Street Address |
700 E WALNUT ST |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952948705 | Alex Morales | Physical Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2019-11-27 |
| 1770992190 | Katrina Mitchell | Occupational Therapist | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-08-11 |
| 1063821882 | Karma Young | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-08-06 |
| 1336558436 | Kristen Stromberg | Physical Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-08-04 |
| 1104236165 | Heritage Enterprises, Inc | Clinic/Center | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-04-30 |
| 1124462288 | Whitney Lynn Harper | Physical Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2013-04-19 |
| 1881038941 | Stephanie Steele | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2013-04-19 |
| 1275877979 | Heritage Manor - Bloomington, LLC | Durable Medical Equipment & Medical Supplies | 700 E Walnut St, Bloomington, IL 61701-3244 | 2012-11-19 |
| 1629321443 | Karen Coakley | Occupational Therapist | 700 E Walnut St, Bloomington, IL 61701-3244 | 2012-10-17 |
| 1316268014 | Renda Watterson | Occupational Therapy Assistant | 700 E Walnut St, Bloomington, IL 61701-3244 | 2010-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| 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 |
|---|---|---|---|---|
| 1023618956 | Empowerme Rehabilitation Illinois, LLC | Skilled Nursing Facility | 3203 E Moores Pike, Bloomington, IN 47401-7122 | 2020-10-29 |
| 1639520034 | Luther Oaks Inc | Skilled Nursing Facility | 601 Lutz Rd, Bloomington, IL 61704-8608 | 2016-06-27 |
| 1447641683 | Daviess County Hospital | Skilled Nursing Facility | 363 S Fieldstone Blvd, Bloomington, IN 47403-9806 | 2015-02-10 |
| 1023425915 | Tanja Lutman | Skilled Nursing Facility | 1207 Dover Rd, Bloomington, IL 61704-7608 | 2014-07-13 |
| 1881009660 | Arba Care Center of Bloomington LLC | Skilled Nursing Facility | 1509 Calhoun St, Bloomington, IL 61701-1514 | 2014-06-30 |
| 1316375686 | Daviess County Hospital | Skilled Nursing Facility | 3043 N Lintel Dr, Bloomington, IN 47404-8945 | 2013-10-24 |
| 1346315165 | Westminster Village Inc | Skilled Nursing Facility | 2025 E. Lincoln, Bloomington, IL 61701-5995 | 2006-11-21 |
| 1598789240 | Presbyterian Homes Bloomington Care Center, Inc | Skilled Nursing Facility | 9889 Penn Ave S, Bloomington, MN 55431-2912 | 2006-07-26 |
| 1821040031 | Hendricks County Hospital | Skilled Nursing Facility | 155 E Burks Dr, Bloomington, IN 47401-8459 | 2006-05-16 |
| 1386695476 | Ggnsc Minneapolis Bloomington LLC | Skilled Nursing Facility | 9200 Nicollet Ave S, Bloomington, MN 55420-3714 | 2006-05-13 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.