Columbia Convalescent Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0037556 Issued in IL

Legal business name

COLUMBIA CONVALESCENT CENTER

Practice address

253 Bradington Dr
Columbia, IL 62236-2519

Phone

(618) 281-6800

Fax

(618) 281-6557

NPI assigned

Nov 9, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dave Wendler

Title

Administrator

Phone

(618) 281-6800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053392894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 BRADINGTON DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362519",
            "telephone_number": "618-281-6800",
            "fax_number": "618-281-6557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 BRADINGTON DR",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622362519",
            "telephone_number": "618-281-6800",
            "fax_number": "618-281-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA CONVALESCENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WENDLER",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-281-6800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0037556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Columbia (City of Columbia Ambulance Service)
• Clarkson Optometry Illinois PC
• Rosa Cole, HIS
• Marlene Colette Coleman, RPH
• Columbia Comm Unit SCH Dist 4
• Columbia Dental Care LTD
• Columbia Dental Center LLC
• Columbia Doctors Group, SC
• Columbia Family Chiropractic, PLLC
• Columbia Orthodontics

• Skilled Nursing Facility in Columbia, IL
• Providers in Columbia, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.