NPIMap

Organization Active NPI

Presence Life Connections

Doing business as Ascension Living Saint Joseph Village

  • Skilled Nursing Facility
  • Freeport, IL
National Provider Identifier
1023004157
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRESENCE LIFE CONNECTIONS
Doing business as
Ascension Living Saint Joseph Village
Practice address
659 E Jefferson Street
Freeport, IL 61032-6027
Phone
(815) 232-6181
Fax
(815) 232-6143
NPI assigned
Sep 23, 2005
Last updated
Jun 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PRESENCE LIFE CONNECTIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Erin Shadbolt
Title
Ceo
Phone
(314) 729-3500

Specialties & licenses 1

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

Addresses

Primary practice location

659 E Jefferson Street
Freeport, IL 61032-6027

Mailing address

18927 Hickory Creek Dr Ste 300
Mokena, IL 60448-8652
Phone (708) 478-6382

Other names 1

  • Ascension Living Saint Joseph Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000141 IL Part A Provider - Skilled Nursing Facility 5092623314 Practice locations: Freeport, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023004157. Details of each certification follow.

Skilled nursing facility certification: CCN 145935

Legal name
PRESENCE LIFE CONNECTIONS
Doing business as
ASCENSION LIVING SAINT JOSEPH VILLAGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Mar 14, 1997
Last certification
Dec 11, 2024
Beds
124
Ownership / control type
Corporation
Multi-facility organization
Citadel Healthcare
Most recent change of ownership
Oct 1, 2025
Organization structure
CorporationNon-profit
Enrollment address
659 E Jefferson St
Freeport, IL 61032-6027

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Citadel at Saint Joseph VillageCCN 145935 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 14, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12491.2 residents per day on average
Penalties (3 years)
7Fines totaling $125,824

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
14D0646721Ascension Saint Joseph Village659 E Jefferson Street, Freeport, IL 61032Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory
Part of
Provena Senior Services

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
Kellie Gronefeld Individual Corporate DirectorSenior Director of Operations Aug 1, 2023
Ascension Health Senior Care Organization, Saint Louis, MO Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 24, 2022 100%
Operational/Managerial Control Mar 24, 2022 100%
Robin Binek Individual Corporate DirectorAvp Finance Jan 1, 2024
Ryan Breedlove Individual Corporate DirectorVP Post Acute & at Home Jan 1, 2024
Lisa Musgrave Individual Corporate DirectorSVP Post Acute Care Jan 1, 2024
Adp of the SNF Jan 1, 2024
Kenneth Smoot Individual Corporate DirectorChief Mission Integrations Officer Jan 1, 2024
Erin Shadbolt Individual Corporate OfficerChief Executive Officer May 22, 2025
Operational/Managerial Control Jan 8, 2026
Adp of the SNF Jan 1, 2024

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1023004157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18927 HICKORY CREEK DR STE 300",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488652",
            "telephone_number": "708-478-6382",
            "fax_number": "708-478-5324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 E JEFFERSON STREET",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326027",
            "telephone_number": "815-232-6181",
            "fax_number": "815-232-6143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE LIFE CONNECTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESENCE LIFE CONNECTIONS",
        "enumeration_date": "2005-09-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A",
        "authorized_official_last_name": "SHADBOLT",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-729-3500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Living Saint Joseph Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, IL

Sources for this page

Verify at the official NPI Registry.