DECATUR HCO, LLC (NPI# 1790318954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790318954 |
| Entity Type | Organization |
| Organization Name | DECATUR HCO, LLC |
| Practice Address |
136 S Dipper Ln Decatur IL 62522-1841 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 2174287767 |
| Mailing Telephone | 3096895880 |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2020-02-17 |
| Authorized Official Name | MARK B. PETERSEN (MANAGER) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
136 S DIPPER LN |
| City | DECATUR |
| State | IL |
| Zip Code | 62522-1841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063459329 | Petersen Health & Wellness, LLC | Nursing Facility/Intermediate Care Facility | 136 S Dipper Ln, Decatur, IL 62522-1841 | 2006-06-02 |
| 1073072609 | Jaycee Cabalatungan Cristales | Physical Therapist | 136 S Dipper Ln, Decatur, IL 62522-1841 | 2019-03-13 |
| 1912482415 | Eleanore Sharon Chan | Speech-Language Pathologist | 136 S Dipper Ln, Decatur, IL 62522-1841 | 2018-10-01 |
| 1700326717 | Jody Veale | Occupational Therapist | 136 S Dipper Ln, Decatur, IL 62522-1841 | 2017-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370299 | Julie Ann Marsh | Psychologist | 7120 W. William St., Decatur, IL 62522 | 2019-01-20 |
| 1588808323 | Paul D. Potter, D.d.s., Ltd | Dentist | 280 West North St, Decatur, IL 62522 | 2009-04-23 |
| 1801059100 | Melissa Ann Burnett | Dentist | 301 W North Street, Decatur, IL 62522 | 2008-07-07 |
| 1801060538 | Ronald James Grason | Internal Medicine | 357 W Decatur St, Decatur, IL 62522 | 2008-04-14 |
| 1033328349 | Jurgens & Kneezel Ltd | Dentist | 334 W Main Street, Decatur, IL 62522 | 2007-05-22 |
| 1740371905 | Randy Curtis Kneezel | Dentist | 334 W Main, Decatur, IL 62522 | 2006-09-27 |
| 1457373375 | Patricia Elaine Norton | Dentist | 1099 W Wood St, Suite E, Decatur, IL 62522 | 2006-07-24 |
| 1104883735 | Stephen J Chadwick | Otolaryngology | 101 W Mckinley Ave, Enta Allergy, Head & Neck Institute, Decatur, IL 62522 | 2006-04-27 |
| 1417408386 | Heritage Behavioral Health Center | Community/Behavioral Health | 955 N Main St, Decatur, IL 62522 | 2016-10-17 |
| 1467522466 | Alan Russell Jurgens | Dentist | 334 W Main, Decatur, IL 62522 | 2006-11-08 |
| Find all providers in zip 62522 | ||||
| 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 |
|---|---|---|---|---|
| 1396308508 | Decatur Operating Group LLC | Skilled Nursing Facility | 332 River Rd, Decatur, TN 37322-7800 | 2019-04-15 |
| 1083132641 | Decatur Healthcare, LLC | Skilled Nursing Facility | 322 River Road, Decatur, TN 38322 | 2017-09-05 |
| 1649722943 | City of Ennis | Skilled Nursing Facility | 701 W Bennett Road, Decatur, TX 76234-3817 | 2016-11-03 |
| 1134458920 | Pruitthealth - Decatur, LLC | Skilled Nursing Facility | 3200 Panthersville Road, Decatur, GA 30034-3831 | 2009-12-08 |
| 1346419397 | Senior Care Resources, Inc. | Skilled Nursing Facility | 701 Bennett Rd, Decatur, TX 76234-3817 | 2008-02-25 |
| 1356476154 | Adams County Memorial Hospital | Skilled Nursing Facility | 1300 Mercer Ave, Decatur, IN 46733-2407 | 2007-02-22 |
| 1417095266 | Lincoln Manor, Inc. | Skilled Nursing Facility | 2650 N Monroe St, Decatur, IL 62526-3251 | 2007-02-02 |
| 1083630487 | Fair Havens Christian Home, Inc. | Skilled Nursing Facility | 1790 S Fairview Ave, Decatur, IL 62521-4010 | 2006-07-15 |
| 1508818766 | Ggnsc Decatur II LLC | Skilled Nursing Facility | 4115 Glenwood Rd, Decatur, GA 30032-4727 | 2006-05-16 |
| 1669424057 | Ggnsc Decatur IIi LLC | Skilled Nursing Facility | 2787 N Decatur Rd, Decatur, GA 30033-5919 | 2006-05-16 |
| Find all providers in DECATUR | ||||
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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.