NPIMap

Organization Active NPI

Petersen Health Business, LLC

  • Skilled Nursing Facility
  • La Harpe, IL
National Provider Identifier
1003943705
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0035741 Issued in IL
Legal business name
PETERSEN HEALTH BUSINESS, LLC
Practice address
101 North B Street
La Harpe, IL 61450-0547
Phone
(217) 659-3222
Fax
(217) 659-3017
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark B Petersen
Title
President
Phone
(309) 691-8113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0035741 IL Primary

Addresses

Primary practice location

101 North B Street
La Harpe, IL 61450-0547

Mailing address

830 W Trailcreek Drive
Peoria, IL 61614
Phone (309) 691-8113

Other names 1

  • LaHarpe Davier HCC Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1003943705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DRIVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NORTH B STREET",
            "city": "LA HARPE",
            "state": "IL",
            "postal_code": "614500547",
            "telephone_number": "217-659-3222",
            "fax_number": "217-659-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN HEALTH BUSINESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0035741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaHarpe Davier HCC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Harpe, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.