HICKORY ESTATES (NPI# 1790981769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790981769 |
| Entity Type | Organization |
| Organization Name | HICKORY ESTATES |
| Practice Address |
310 Otha Sumner IL 62466 |
| Mailing Address |
Po Box 164 310 Otha Sumner IL 62466-0164 |
| Practice Telephone | 6189362004 |
| Practice Fax Number | 6189362556 |
| Mailing Telephone | 6189362004 |
| Mailing Fax Number | 6189362556 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SHEILA KAY HAYES (ASST. ADM.) |
| Authorized Official Telephone | 6189362004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 177F00000X | Lodging | 0030510 | IL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013182807 | Hickory Estates | Intermediate Care Facility, Mentally Retarded | 310 Otha Street, Sumner, IL 62466-0164 | 2008-04-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Hickory Estates, LLC | 4285 Brentwood Drive, Wheat Ridge, CO 80033 |
| New York State Corporations | HICKORY ESTATES, LLC | 301 Riverside Drive, Binghamton, Ny 13905 |
| Street Address |
310 OTHA |
| City | SUMNER |
| State | IL |
| Zip Code | 62466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013182807 | Hickory Estates | Intermediate Care Facility, Mentally Retarded | 310 Otha Street, Sumner, IL 62466-0164 | 2008-04-23 |
| 1932313855 | Kathy Cotterell | Speech-Language Pathologist | 222 E North Ave, Sumner, IL 62466-1005 | 2007-05-09 |
| 1912998733 | Sumner Health Clinic, Ltd. | Chiropractor | 102 S Christy Ave, Sumner, IL 62466-1027 | 2005-11-01 |
| 1356545859 | Kevin D Sager | Chiropractor | 102 S Christy Ave, Sumner, IL 62466-1027 | 2007-06-11 |
| 1245880020 | Sara Stover | Nurse Practitioner | 10940 Lawrence Rd, Sumner, IL 62466-4915 | 2019-09-13 |
| 1588285878 | Lynda Hoke | Nurse Practitioner | 10940 Lawrence Rd, Sumner, IL 62466-4915 | 2020-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113304 | Tasha Rucker | Nurse Practitioner | 2372 Us49-e, Sumner, MS 38957 | 2020-10-27 |
| 1720690506 | Total Renal Care Inc | Clinic/Center | 16290 Auto Ln, Sumner, WA 98390-2568 | 2020-08-21 |
| 1154939965 | Ann Marie Bock | Nurse Practitioner | 15178 V Ave, Sumner, IA 50674-7622 | 2020-07-17 |
| 1780209205 | Monica Leigh Hevron | Nurse Practitioner | 516 County Road 32200, Sumner, TX 75486-5707 | 2020-06-10 |
| 1225676703 | Lynn Dishman | Nurse Practitioner | 12516 Farm Road 79, Sumner, TX 75486-5534 | 2019-12-16 |
| 1376181990 | Cassidy Bayou Medical Clinic | Family Medicine | 2372 Us 49-e, Sumner, MS 38957 | 2019-12-13 |
| 1558902130 | Morgan Lindsey Smith | Nurse Practitioner | 3187 Farm Road 2820, Sumner, TX 75486-5611 | 2019-10-04 |
| 1801437363 | Permelia May Foster | Counselor | 1325 Bonney Ave Apt 1, Sumner, WA 98390-2104 | 2019-10-04 |
| 1235798661 | Marjory Ware | Counselor | 1818 Main St Ste C, Sumner, WA 98390-1853 | 2019-06-10 |
| 1225510746 | Amanda Giberson | Licensed Vocational Nurse | 1280 County Road 32220, Sumner, TX 75486-5654 | 2018-08-30 |
| Find all providers in SUMNER | ||||
| Taxonomy Code | 177F00000X |
| Grouping | Other Service Providers |
| Classification | Lodging |
| A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588784136 | Maple House Shelter Care Home, Inc. | Lodging | 205 E 3rd St, Johnston City, IL 62951-1624 | 2007-03-29 |
Please comment or provide details below to improve the information on HICKORY ESTATES.
| 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.