HERITAGE MANOR GILLESPIE, LLC (NPI# 1508857459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508857459 |
| Entity Type | Organization |
| Organization Name | HERITAGE MANOR GILLESPIE, LLC |
| Other Organization Name | HERITAGE HEALTH - GILLESPIE |
| Practice Address |
7588 Staunton Rd Gillespie IL 62033-3232 |
| Mailing Address |
115 W Jefferson St Suite 401 Bloomington IL 61701-3946 |
| Practice Telephone | 2178392171 |
| Practice Fax Number | 2178391372 |
| Mailing Telephone | 3098284361 |
| Mailing Fax Number | 3098299512 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2014-05-27 |
| Authorized Official Name | MR. 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 | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
0048892 | IL | Suppliers |
| Y | 314000000X | Skilled Nursing Facility | 048892 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Health - Gillespie | Doing Business As Name - Organization |
| Street Address |
7588 STAUNTON RD |
| City | GILLESPIE |
| State | IL |
| Zip Code | 62033-3232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801130513 | Heritage Manor - Gillespie, LLC | Durable Medical Equipment & Medical Supplies | 7588 Staunton Rd, Gillespie, IL 62033-3232 | 2012-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225596950 | Laura Michelle Halpin | Physical Therapist | 607 Litchfield Road, Gillespie, IL 62033 | 2019-03-12 |
| 1770942716 | Carol Candler | Nurse Practitioner | 109 East Maple Street, Maucoupin County Maple Street Clinic, Gillespie, IL 62033 | 2016-02-18 |
| 1932519618 | Terry Allan | Pharmacist | 113 South Macoupin Street, Gillespie, IL 62033 | 2014-05-02 |
| 1649414558 | Bernadette Kathlene Sobczak | Nurse Practitioner | 807 Broadway, Gillespie, IL 62033 | 2009-04-22 |
| 1376765206 | Sheri Lynne Banovic | Nurse Practitioner | 115 South Macoupin Street, Gillespie, IL 62033 | 2007-05-02 |
| 1215044920 | James Paul Verton | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1427575612 | Beth Lynn Sies | Speech-Language Pathologist | 340 Kelly St, Gillespie, IL 62033 | 2017-08-28 |
| 1356599971 | Julia Terese Ruckman | Social Worker | 109 E Maple St, Gillespie, IL 62033 | 2008-09-08 |
| 1124135835 | Bruce W Hughes | Pharmacist | 120 S Macoupin, Dippold Drug Co Inc, Gillespie, IL 62033 | 2006-08-25 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| Find all providers in zip 62033 | ||||
| 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. |
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|---|---|---|---|---|
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| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1902428147 | Aperion Care Glenwood LLC | Skilled Nursing Facility | 19330 South College Grove, Glenwood, IL 60425 | 2020-05-11 |
| 1487273330 | Residential Alternatives of Illinois, Inc | Skilled Nursing Facility | 2203 Flagg Rd, Rochelle, IL 61068 | 2020-04-10 |
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 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 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
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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.