KATHERINE SHAW BETHEA HOSPITAL (NPI# 1962600072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962600072 |
| Entity Type | Organization |
| Organization Name | KATHERINE SHAW BETHEA HOSPITAL |
| Practice Address |
403 E 1st St Dixon IL 61021-3116 |
| Practice Telephone | 8152885531 |
| Practice Fax Number | 8152855688 |
| Mailing Telephone | 8152885531 |
| Mailing Fax Number | 8152855688 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DARRYL VANDERVORT (CEO) |
| Authorized Official Telephone | 8152855501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | 0000497 | IL | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043546 | Katherine Shaw Bethea Hospital | General Acute Care Hospital | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-14 |
| 1912404765 | Katherine Shaw Bethea Hospital | Medicare Defined Swing Bed Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2018-04-09 |
| 1497281620 | Katherine Shaw Bethea Hospital | Pharmacy | 403 E 1st St, Dixon, IL 61021-3116 | 2017-05-09 |
| 1205031721 | Katherine Shaw Bethea Hospital | Hospice Care, Community Based | 101 W 2nd St, Suite 203, Dixon, IL 61021-3076 | 2007-06-15 |
| 1811987134 | Katherine Shaw Bethea Hospital | Home Health | 101 W 2nd St, Suite 203, Dixon, IL 61021-3076 | 2005-10-27 |
| 1770578395 | Katherine Shaw Bethea Hospital | Personal Emergency Response Attendant | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-20 |
| 1023003720 | Katherine Shaw Bethea Hospital | Psychiatric Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-19 |
| Street Address |
403 E 1ST ST |
| City | DIXON |
| State | IL |
| Zip Code | 61021-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427043546 | Katherine Shaw Bethea Hospital | General Acute Care Hospital | 403 E 1st St, Dixon, IL 61021-3116 | 2005-09-14 |
| 1063029247 | Valarie Pfoutz | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-30 |
| 1639786288 | Stephanie Marie Berlin | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-28 |
| 1639786270 | Marissa Leigh Frost | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-28 |
| 1588270797 | Tiffany L Hummel | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2020-09-22 |
| 1811513641 | Beth Barbara Reittinger | Podiatrist | 403 E 1st St, Dixon, IL 61021-3116 | 2020-06-17 |
| 1205458528 | Andres David Arellano | Physical Therapist | 403 E 1st St, Dixon, IL 61021-3116 | 2020-05-08 |
| 1144856667 | Connor Skoumal | Physical Therapist | 403 E 1st St, Dixon, IL 61021-3116 | 2020-03-16 |
| 1760022180 | Chris A Herbert | Emergency Medicine | 403 E 1st St, Dixon, IL 61021-3187 | 2020-01-14 |
| 1508414756 | Ann C Lee | Nurse Practitioner | 403 E 1st St, Dixon, IL 61021-3116 | 2019-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912404765 | Katherine Shaw Bethea Hospital | Medicare Defined Swing Bed Unit | 403 E 1st St, Dixon, IL 61021-3116 | 2018-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316169949 | Alexian Brothers Medical Center | Medicare Defined Swing Bed Unit | 800 Biesterfield Rd Ste 605, Eberle Medical Office Building, Elk Grove Village, IL 60007-3362 | 2007-05-03 |
| 1902854623 | Cgh Medical Center | Medicare Defined Swing Bed Unit | 100 E Le Fevre Rd, Sterling, IL 61081-1278 | 2006-05-05 |
| 1336638915 | Valley West Community Hospital | Medicare Defined Swing Bed Unit | 1302 N Main St, Sandwich, IL 60548-2587 | 2018-05-09 |
| 1447747316 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Medicare Defined Swing Bed Unit | 9515 Holy Cross Ln, Breese, IL 62230-3618 | 2018-04-17 |
| 1801212055 | Osf Healthcare System | Medicare Defined Swing Bed Unit | 1051 W South St, Kewanee, IL 61443-8354 | 2014-03-12 |
| 1639595036 | Southern Illinois Hospital Services | Medicare Defined Swing Bed Unit | 2 S Hospital Dr, Murphysboro, IL 62966-3333 | 2014-03-10 |
| 1295066983 | Advocate Health and Hospitals Corp. | Medicare Defined Swing Bed Unit | 101 S Major St, Eureka, IL 61530-1246 | 2010-01-20 |
| 1114199122 | Accuracy Urgent Care | Medicare Defined Swing Bed Unit | 805 W Deyoung St, Suite E, Marion, IL 62959-1604 | 2008-03-31 |
| 1174713440 | St Francis Hospital Sisters of The Third Order of St Francis | Medicare Defined Swing Bed Unit | 1215 Franciscan Dr, Box 1215, Litchfield, IL 62056-1778 | 2007-08-01 |
| 1336345578 | County of Clay | Medicare Defined Swing Bed Unit | 911 Stacey Burk Dr, Flora, IL 62839-3241 | 2007-06-25 |
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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.