FAIRFIELD MEMORIAL HOSPITAL (NPI# 1821186479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821186479 |
Entity Type | Organization |
Organization Name | FAIRFIELD MEMORIAL HOSPITAL |
Other Organization Name | WAYFAIR NURSING HOME |
Practice Address |
303 Nw 11th St Fairfield IL 62837-1203 |
Practice Telephone | 6188478260 |
Practice Fax Number | 6188478387 |
Mailing Telephone | 6188478260 |
Mailing Fax Number | 6188478387 |
Enumeration Date | 2006-10-10 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. MICHAEL J BROWN (CFO) |
Authorized Official Telephone | 6188478260 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 0040238 | IL | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BCBS | 1049 | 01 |
Other Name | Type Code |
---|---|
WAYFAIR NURSING HOME | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992018691 | Fairfield Memorial Hospital | Clinic/Center | 880 West Moultrie Street, Suite 3, Winnsboro, SC 29180-2411 | 2010-07-22 |
1154463115 | Fairfield Memorial Hospital | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 102 Us Hwy 321 By Pass N, Winnsboro, SC 29180 | 2007-02-13 |
1487702973 | Fairfield Memorial Hospital | Medicare Defined Swing Bed Unit | 102 Us Hwy 321 Bypass N, Winnsboro, SC 29180 | 2007-01-08 |
1386604726 | Fairfield Memorial Hospital | General Acute Care Hospital | 102 Us Highway 321 Byp N, Winnsboro, SC 29180-9251 | 2006-03-27 |
1558418111 | Fairfield Memorial Hospital | Pharmacy | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2007-01-05 |
1750438362 | Fairfield Memorial Hospital | Pharmacy | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2007-01-04 |
1770594277 | Fairfield Memorial Hospital | Pharmacy | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2006-08-10 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | FAIRFIELD MEMORIAL HOSPITAL | 102 Us Highway 321 Byp N, Winnsboro, SC 29180-9251 |
System for Award Management (SAM) Entities | FAIRFIELD MEMORIAL HOSPITAL ASSOCIATION | 303 Northwest 11th St, Fairfield, IL 62837-1203 |
Street Address |
303 NW 11TH ST |
City | FAIRFIELD |
State | IL |
Zip Code | 62837-1203 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518910330 | Christopher D Beehn | Physical Therapist | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2006-05-19 |
1093345167 | Dana Shantel Taylor | Social Worker | 303 Nw 11th St, Fairfield, IL 62837-1206 | 2020-01-17 |
1962983338 | Sherrill Kay Funkhouser | Physician Assistant | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2018-08-23 |
1124494174 | Mary Lou Mcculley | Health Educator | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2015-08-13 |
1548657158 | Dylan Wayne Stennett | Nurse Practitioner | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2015-04-21 |
1063802916 | Whitney Elaine Buckles | Dietitian, Registered | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2015-01-30 |
1649442419 | Fairfield Memorial Hospital Association | Family Medicine | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2008-04-01 |
1295920387 | Total Renal Care Inc | Clinic/Center | 303 Nw 11th St, Ste 1, Fairfield, IL 62837-1203 | 2007-09-11 |
1790982650 | April Joy Best | Speech-Language Pathologist | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2007-07-02 |
1558418111 | Fairfield Memorial Hospital | Pharmacy | 303 Nw 11th St, Fairfield, IL 62837-1203 | 2007-01-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881294619 | Katelyn Atteberry | Pharmacist | 150 Commerce Drive, Fairfield, IL 62837 | 2020-10-30 |
1265894521 | Rebecca August | Social Worker | 506 Nw 9th St, Fairfield, IL 62837 | 2016-03-25 |
1063814259 | Kathie L Hill | Social Worker | 303 Nw 11th St., Fairfield Memorial Hospital, Fairfield, IL 62837 | 2014-09-19 |
1912206731 | Way-fair Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 305 Northwest 11th Street, Fairfield, IL 62837 | 2011-03-18 |
1063600773 | Alvin Ewing | Counselor | 407 N. Basin Road, Fairfield, IL 62837 | 2007-10-09 |
1417145129 | Gilbert Tennyson | Counselor | 407 North Basin Rd, Fairfield, IL 62837 | 2007-10-09 |
1972791689 | Clint Harvey | Counselor | 407 North Basin Road, Fairfield, IL 62837 | 2007-10-09 |
1770789778 | Fairfield Estates, LLC | Point of Service | 315 North Market Street, Fairfield, IL 62837 | 2007-06-26 |
1346382207 | Robert E Lowry | Counselor | 407 N Basin Rd., Fairfield, IL 62837 | 2007-02-13 |
1790840825 | Bradley D Kramer | Dentist | 301 Nw 11th Street, Suite 212, Fairfield, IL 62837 | 2006-12-27 |
Find all providers in zip 62837 |
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. |
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1235563701 | Na | Nursing Facility/Intermediate Care Facility | 3385 Greenwich Dr, Fairfield, OH 45014-5322 | 2013-09-02 |
1952687279 | Michael's Project, Inc | Nursing Facility/Intermediate Care Facility | 3038 Pecan Cir, Fairfield, CA 94533-7013 | 2011-11-01 |
1013125749 | Michaels Project Inc | Nursing Facility/Intermediate Care Facility | 1132 Gulf Dr, Fairfield, CA 94533-7716 | 2007-05-18 |
1871700369 | Michaels Project Inc | Nursing Facility/Intermediate Care Facility | 1152 Hickory Ave, Fairfield, CA 94533-7094 | 2007-05-16 |
1780776252 | Parkview Care Center Inc | Nursing Facility/Intermediate Care Facility | 2237 Highway 34, Fairfield, IA 52556-8560 | 2006-09-29 |
1871690289 | Jefferson County Hospital | Nursing Facility/Intermediate Care Facility | 400 Highland St, Fairfield, IA 52556-3713 | 2006-09-20 |
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 |
1699936054 | Pinckneyville Healthcare Center | Nursing Facility/Intermediate Care Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2008-06-18 |
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 |
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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.