JAVON BEA HOSPITAL (NPI# 1629118609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629118609 |
| Entity Type | Organization |
| Organization Name | JAVON BEA HOSPITAL |
| Practice Address |
2400 N Rockton Ave Rockford IL 61103 |
| Mailing Address |
2400 N Rockton Ave Rockford IL 61103-3655 |
| Practice Telephone | 8159715000 |
| Practice Fax Number | 8159680170 |
| Mailing Telephone | 8159715000 |
| Mailing Fax Number | 8159680170 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-07-23 |
| Authorized Official Name | TODD ANDERSON (VP/CFO) |
| Authorized Official Telephone | 6087566000 |
| Is Organization Subpart | Y |
| Parent Organization Name | MERCY HEALTH CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 0002048 | IL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 11002400 | 05 | |
| PA | 1121340 | 05 | |
| IA | 0927533 | 05 | |
| IN | 100034510A | 05 | |
| BCBS | 372 | 01 | |
| MO | 011307204 | 05 | |
| NC | 1400239 | 05 | |
| MN | 720850200 | 05 | |
| CA | XHSP30083 | 05 | |
| AR | 108771105 | 05 | |
| FL | 090109100 | 05 | |
| IL | IL MEDICARE | 140239 | 01 |
| Other Name | Type Code |
|---|---|
| Mercyhealth Hospital - Rockton Avenue | Doing Business As Name - Organization |
| Rockford Memorial Hospital | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3401 N Perryville Rd, Rockford, IL 611148011 | 8159715000 | 8159684795 |
| 8201 E Riverside Blvd, Rockford, IL 611142300 | 8159717000 | 8159684795 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144790791 | Javon Bea Hospital | Pharmacy | 8201 E Riverside Blvd Ste 1022, Rockford, IL 61114-2300 | 2018-11-27 |
| 1811488109 | Javon Bea Hospital | General Acute Care Hospital | 8201 E Riverside Blvd, Rockford, IL 61114-2300 | 2018-05-23 |
| 1437367166 | Javon Bea Hospital | Psychiatric Unit | 2400 N Rockton Ave, Rockford, IL 61103 | 2007-05-18 |
| Street Address |
2400 N ROCKTON AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357592 | Michael J Kikta | Surgery | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2005-06-23 |
| 1053950055 | Tina Longphee | Registered Nurse | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-12-23 |
| 1598227407 | Shahid Mohammad | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-04-01 |
| 1265993109 | Sarah Elaine Robertson | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-25 |
| 1770042525 | Vinita Patel | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-19 |
| 1255890646 | Gilda Djabarzade | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-15 |
| 1285103002 | Amy Lask | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-11-21 |
| 1477038743 | Michelle Harris | Advanced Practice Midwife | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-10-02 |
| 1134603095 | Sarah R Linder | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-09-17 |
| 1376022350 | Atiq Urrehman Khan | Psychiatry & Neurology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398497 | The Elitist Group | Home Health Aide | 2929 N Main Street, Rockford, IL 61103 | 2020-02-19 |
| 1972064194 | Mahita Bellamkonda | Student in an Organized Health Care Education/Training Program | 2400 North Rockton Avenue, Rockford, IL 61103 | 2019-03-29 |
| 1558538967 | Willows Health Center | Clinic/Center | 4143 Albright Lane, Rockford, IL 61103 | 2008-05-14 |
| 1497845135 | Humaira Bari | Internal Medicine | 2400 N. Rockton Avenue, Rockford, IL 61103 | 2006-10-13 |
| 1841385242 | Rachel Pawlowski | Occupational Therapist | 3616 N. Main Street, Rockford, IL 61103 | 2006-10-03 |
| 1417068438 | Alicia Anne Huntley | Midwife | 2400 Rockton Ave, Rockford, IL 61103 | 2006-08-31 |
| 1639190200 | Glendon Burress | Pediatrics | 2300 N. Rockton Ave., Rockford Health Physicians, Rockford, IL 61103 | 2006-07-21 |
| 1225065204 | Daniel William Johnson | Dentist | 519 Toner Av, Rockford, IL 61103 | 2006-06-27 |
| 1760472898 | Ronald Peter Oberfoell | Anesthesiology | 2400 North Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | 2005-10-28 |
| 1841752532 | Dipti Sabharwal | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Avenue, Rockford, IL 61103 | 2019-04-02 |
| Find all providers in zip 61103 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992813661 | Saint Anthony Medical Center | General Acute Care Hospital | 5666 E State St, Rockford, IL 61108-2425 | 2006-08-25 |
| 1790739977 | Saint Anthony Medical Center | General Acute Care Hospital | 5666 E State St, Rockford, IL 61108-2425 | 2006-05-20 |
| 1780665133 | H. Douglas Singer Mental Health Center | General Acute Care Hospital | 4402 N Main St, Rockford, IL 61103-1278 | 2005-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619442266 | Pipeline-west Suburban Medical Center, LLC | General Acute Care Hospital | West Suburban Medical Center, 3 Erie Court, Oak Park, IL 60302-2519 | 2018-10-10 |
| 1093241275 | Northwest Community Hospital | General Acute Care Hospital | 2704 Royal Saint Georges Ct, Saint Charles, IL 60174-8754 | 2017-05-05 |
| 1831620632 | Macneal Hospital | General Acute Care Hospital | 665 Grove Dr Apt 112, Buffalo Grove, IL 60089-4038 | 2017-03-23 |
| 1801337506 | University of Chicago Medical Center | General Acute Care Hospital | 1122 Paysphere Cir, Chicago, IL 60674-0011 | 2017-03-14 |
| 1861935181 | Sarah Landon | General Acute Care Hospital | 6407 Martin St, Crystal Lake, IL 60014-4959 | 2016-11-19 |
| 1942750831 | Advocate Good Samaritan | General Acute Care Hospital | 4427 Woodward Ave, Downers Grove, IL 60515 | 2016-10-04 |
| 1063960870 | Mid America Emergency Medicine | General Acute Care Hospital | 700 N First St, Springfield, IL 62781-0001 | 2016-09-21 |
| 1336598937 | Daniel Benjamin Holt Jr. | General Acute Care Hospital | 2448 N Seminary Ave, Apt 2b, Chicago, IL 60614-7445 | 2016-06-06 |
| 1841650942 | Latoyia Roman | General Acute Care Hospital | 6756 S Oglesby Ave, Unit 1, Chicago, IL 60649-1316 | 2016-03-02 |
| 1306203583 | Rush University Medical Center | General Acute Care Hospital | 4536 N Greenview Ave Apt 2n, Chicago, IL 60640-5475 | 2016-01-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JAVON BEA HOSPITAL.
| 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.