PINCKNEYVILLE HEALTHCARE CENTER (NPI# 1699936054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699936054 |
| Entity Type | Organization |
| Organization Name | PINCKNEYVILLE HEALTHCARE CENTER |
| Practice Address |
708 Virginia Ct Pinckneyville IL 62274-1538 |
| Practice Telephone | 6183572493 |
| Practice Fax Number | 6183579610 |
| Mailing Telephone | 6183572493 |
| Mailing Fax Number | 6183579610 |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | MR. TIMMY DALE CONNER JR. (DIRECTOR OF NURSING) |
| Authorized Official Telephone | 6183572493 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 0045260 | IL | Nursing & Custodial Care Facilities |
| Street Address |
708 VIRGINIA CT |
| City | PINCKNEYVILLE |
| State | IL |
| Zip Code | 62274-1538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013456490 | Pinckneyville Nursing & Rehabilitation Center, LLC | Skilled Nursing Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2017-02-17 |
| 1902229537 | Pinckneyville Nursing & Rehabilitation Center, LLC | Skilled Nursing Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2014-02-03 |
| 1841443751 | L. Lee Sparks | Occupational Therapist | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2008-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912260233 | Kathy Lynn Heard | Physical Therapy Assistant | 101 N. Walnut St., Pinckneyville, IL 62274 | 2012-06-21 |
| 1235254350 | Timothy Alan Mathis | Emergency Medicine | 202 S Walnut St, Pinckneyville, IL 62274 | 2007-03-20 |
| 1225194988 | Perry County Trans Van | Non-emergency Medical Transport (VAN) | 602 S Douglas St, Pinckneyville, IL 62274 | 2006-12-28 |
| 1063591261 | Medical Arts Sc | Family Medicine | 13 North Walnut Street, Pinckneyville, IL 62274 | 2006-11-06 |
| 1588670426 | Ralph Kane Chapman | Dentist | Box 469, 314 W South St, Pinckneyville, IL 62274 | 2006-07-31 |
| 1427456961 | Alisa D Dearmond | Nurse Practitioner | 5383 State Route 154, Pinckneyville, IL 62274 | 2014-12-16 |
| 1619210721 | Andrea Marie Epplin | Nurse Practitioner | 5383 State Route 154, Family Medical Center, Pinckneyville, IL 62274 | 2013-03-27 |
| 1841336799 | Clinic Pharmacy | Pharmacy | 206 North Main Street, Pinckneyville, IL 62274-0364 | 2007-01-29 |
| 1992840821 | Wayne Ray Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2007-02-20 |
| 1194384669 | Thaddeus Hawkins | Dentist | 212 N Walnut St, Pinckneyville, IL 62274-1015 | 2019-06-10 |
| Find all providers in zip 62274 | ||||
| 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 |
| 1215188487 | Petersen Health Care, Inc | Nursing Facility/Intermediate Care Facility | 144 Jounior Ave., Kewanee, IL 61443 | 2008-10-07 |
| 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 | ||||
| City | PINCKNEYVILLE |
| Zip Code | 62274 |
Please comment or provide details below to improve the information on PINCKNEYVILLE HEALTHCARE CENTER.
| 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.