EDWARDSVILLE CARE CENTER, LLC (NPI# 1518475524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518475524 |
| Entity Type | Organization |
| Organization Name | EDWARDSVILLE CARE CENTER, LLC |
| Other Organization Name | EDWARDSVILLE NURSING & REHABILIATION CENTER |
| Practice Address |
401 Saint Marys Dr Edwardsville IL 62025-4276 |
| Mailing Address |
1401 S Brentwood Blvd Ste 475 Brentwood MO 63144-1437 |
| Practice Telephone | 6186921330 |
| Mailing Telephone | 3149637570 |
| Mailing Fax Number | 3149639030 |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |
| Authorized Official Name | MR. MAKHLOUF SUISSA (MANAGER/MEMBER OF LLC) |
| Authorized Official Telephone | 9177448688 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Edwardsville Nursing & Rehabiliation Center | Doing Business As Name - Organization |
| Street Address |
401 SAINT MARYS DR |
| City | EDWARDSVILLE |
| State | IL |
| Zip Code | 62025-4276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558343301 | St. Marys Health Care Center Investors LLC | Custodial Care Facility | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2005-11-17 |
| 1679929368 | St. Marys Health Care Center Investors LLC | Durable Medical Equipment & Medical Supplies | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2016-05-11 |
| 1831576503 | Brittne Hall | Occupational Therapy Assistant | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2015-05-01 |
| 1255682209 | Janet L. Logsdon | Occupational Therapy Assistant | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2012-09-29 |
| 1831446103 | Joan Lingle | Physical Therapy Assistant | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2012-08-06 |
| 1902152333 | Janet Elaine Barker | Physical Therapy Assistant | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2012-08-03 |
| 1235485764 | Mary Ellen Sandrin | Occupational Therapy Assistant | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2012-08-02 |
| 1750637500 | Keli Ann Hatfield | Occupational Therapist | 401 Saint Marys Dr, Edwardsville, IL 62025-4276 | 2012-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619519535 | Anderson Surgery Center LLC | Clinic/Center | 3403 Anderson Healthcare Drive, Edwardsville, IL 62025 | 2019-10-11 |
| 1194376640 | Katharine Mcginnis D.m.d. P.C. | Dentist | 235 A. South Main St, Edwardsville, IL 62025 | 2019-09-26 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1902277031 | Amy Lynn Britt | Nurse Practitioner | 1188 South State Route 157, Edwardsville, IL 62025 | 2015-10-15 |
| 1730563230 | Jenna Dallman | Chiropractor | 3 Sunset Hills Professional Center, Suite 2, Edwardsville, IL 62025 | 2015-07-14 |
| 1861745218 | Srimannarayana Marella | Family Medicine | 6616 Center Grove Rd., Edwardsville, IL 62025 | 2012-10-23 |
| 1669722872 | Ican Clinic LLC | Chiropractor | 441 S State Route 157 Ste 2, Edwardsville, IL 62025 | 2012-09-14 |
| 1922371673 | Teresa Marie Garbett | Pharmacist | 2 Sunset Hills Executive Park Dr., Addiction Treatment Strategies, Edwardsville, IL 62025 | 2012-02-10 |
| 1831324342 | Krista Nicole Nelson | Podiatrist | 235 S Main St Ste B, Edwardsville, IL 62025 | 2009-05-28 |
| 1447415757 | Harvey H Breckner D.m.d.,m.s | Exclusive Provider Organization | 600 Country Club View Suite 4, Edwardsville, IL 62025 | 2008-07-25 |
| Find all providers in zip 62025 | ||||
| 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 |
|---|---|---|---|---|
| 1679524839 | Ggnsc Edwardsville IIi LLC | Skilled Nursing Facility | 751 Blake St, Edwardsville, KS 66111-1338 | 2006-05-13 |
| 1689625006 | Ggnsc Edwardsville Parkway LLC | Skilled Nursing Facility | 749 Blake St, Edwardsville, KS 66111-1338 | 2006-05-12 |
| 1225089501 | Ggnsc Edwardsville II LLC | Skilled Nursing Facility | 750 Blake St, Edwardsville, KS 66111-1339 | 2006-05-12 |
| 1497755094 | Edwardsville Health Care Center Investors LLC | Skilled Nursing Facility | 1095 University Dr, Edwardsville, IL 62025-3961 | 2005-07-26 |
| 1437708427 | Kaw River Operator, LLC | Skilled Nursing Facility | 750 Blake St, Edwardsville, KS 66111-1339 | 2019-09-11 |
| 1487203444 | Edwardsville Operator, LLC | Skilled Nursing Facility | 751 Blake St, Edwardsville, KS 66111-1338 | 2019-09-11 |
| 1770132763 | Parkway Operator, LLC | Skilled Nursing Facility | 749 Blake St, Edwardsville, KS 66111-1338 | 2019-09-11 |
| 1023526035 | University Care Center, LLC | Skilled Nursing Facility | 1095 University Dr, Edwardsville, IL 62025-3961 | 2018-01-12 |
| 1730622457 | Edwardsville Nh LLC | Skilled Nursing Facility | 6277 Center Grove Rd, Edwardsville, IL 62025-3309 | 2016-11-29 |
| 1831646611 | Edwardsville Care and Rehabilitation Center, LLC | Skilled Nursing Facility | 751 Blake St, Edwardsville, KS 66111-1338 | 2016-09-08 |
| Find all providers in EDWARDSVILLE | ||||
| City | EDWARDSVILLE |
| Zip Code | 62025 |
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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.