NPIMap

Organization Active NPI

Carrier Mills Nursing & Rehabilitation Center, Inc

  • Skilled Nursing Facility
  • Carrier Mills, IL
National Provider Identifier
1073509113
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
000025130 Issued in IL
Legal business name
CARRIER MILLS NURSING & REHABILITATION CENTER, INC
Practice address
6789 US Highway 45 S
Carrier Mills, IL 62917-1225
Phone
(618) 994-2323
Fax
(618) 994-4082
NPI assigned
Sep 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Authorized official

Name
Mr. Scot E. Stout, LNHA
Title
Executive Director
Phone
(618) 994-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 000025130 IL Primary

Addresses

Primary practice location

6789 US Highway 45 S
Carrier Mills, IL 62917-1225

Mailing address

6789 US Highway 45 S
P O Box 68
Carrier Mills, IL 62917-1225
Phone (618) 994-2323

Other identifiers 1

IdentifierTypeStateIssuer
37112696001MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Carrier Mills Nursing Rehab Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1487030400000",
    "number": "1073509113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6789 US HIGHWAY 45 S",
            "address_2": "P O BOX 68",
            "city": "CARRIER MILLS",
            "state": "IL",
            "postal_code": "629171225",
            "telephone_number": "618-994-2323",
            "fax_number": "618-994-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6789 US HIGHWAY 45 S",
            "city": "CARRIER MILLS",
            "state": "IL",
            "postal_code": "629171225",
            "telephone_number": "618-994-2323",
            "fax_number": "618-994-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARRIER MILLS NURSING & REHABILITATION CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "SCOT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-994-2323",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "000025130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37112696001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrier Mills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.