NPIMap

Organization Active NPI

Unlimited Development, Inc

Doing business as UDI NO2 Manor Court of Maryville

  • Skilled Nursing Facility
  • Maryville, IL
National Provider Identifier
1013904366
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
48462 Issued in IL
Legal business name
UNLIMITED DEVELOPMENT, INC
Doing business as
UDI NO2 Manor Court of Maryville
Practice address
6955 State Route 162
Maryville, IL 62062-8531
Phone
(618) 288-5999
Fax
(618) 288-1106
NPI assigned
Oct 3, 2005
Last updated
Jan 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Authorized official

Name
Mr. Ronald J Wilson
Title
Cfo
Phone
(309) 343-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 48462 IL Primary

Addresses

Primary practice location

6955 State Route 162
Maryville, IL 62062-8531

Mailing address

6955 State Route 162
Maryville, IL 62062-8531
Phone (618) 288-5999

Other names 1

  • UDI NO2 Manor Court of Maryville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090720000069 IL Part A Provider - Skilled Nursing Facility 6901995513 Practice locations: Maryville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013904366. Details of each certification follow.

Skilled nursing facility certification: CCN 145728

Legal name
UNLIMITED DEVELOPMENT, INC
Doing business as
MANOR COURT OF MARYVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 19, 1992
Last certification
Nov 1, 2024
Beds
132
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Unlimited Development INC
Organization structure
CorporationNon-profit
Incorporated
May 17, 1996 in IL
Enrollment address
6955 State Route 162
Maryville, IL 62062-8531
Nursing home name
MANOR COURT OF MARYVILLE
Affiliated entity
UNLIMITED DEVELOPMENT, INC.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Manor Court of MaryvilleCCN 145728 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 19, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
132112.4 residents per day on average
Chain
Unlimited Development, Inc.10 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0861769Manor Court of Maryville6955 State Route 162, Maryville, IL 62062Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Unlimited Development Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Audrey J Finke Individual Corporate OfficerSecretary of Board of Directors Aug 30, 2018
Corporate DirectorDirector Oct 1, 2006
Jerry D Gilmore Individual Corporate Director Oct 1, 2006
Ronald J Wilson Individual Corporate OfficerChief Financial Officer Aug 30, 2018
Johnny Gordon Law Individual W-2 Managing EmployeeAdministrator Aug 30, 2018
David S Haney Individual Corporate Director Oct 1, 2006
Unlimited Development, Inc Organization, Galesburg, IL Non-profit 5% Or Greater Indirect Ownership Interest Jan 7, 2014 100%
Operational/Managerial Control Jan 16, 2014
Robert H Wagner Individual Corporate Director Oct 1, 2006

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Seminary ManorGalesburg, IL, CCN 145598 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2009
Parkway ManorMarion, IL, CCN 145841 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2009
Pekin ManorPekin, IL, CCN 145597 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jun 1, 2009
Centralia ManorCentralia, IL, CCN 145666 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jun 1, 2009
River Hills VillageKeokuk, IA, CCN 165396 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2010

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1013904366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6955 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628531",
            "telephone_number": "618-288-5999",
            "fax_number": "618-288-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6955 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628531",
            "telephone_number": "618-288-5999",
            "fax_number": "618-288-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNLIMITED DEVELOPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-343-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "48462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UDI NO2 Manor Court of Maryville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.