Dixon Peoples Home Fund Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0018176 Issued in IL

Legal business name

DIXON PEOPLES HOME FUND INC

Doing business as

Heritage Square

Practice address

620 N Ottawa
Dixon, IL 61021

Phone

(815) 288-2251

Fax

(815) 288-6821

NPI assigned

Feb 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Norman John Gross, BS MS LNHA

Title

Administration Long Term Care

Phone

(815) 288-2251

Specialties & licenses 1

Addresses

Other names 1

• Heritage Square Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083680672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N OTTAWA",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-288-2251",
            "fax_number": "815-288-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N OTTAWA",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "61021",
            "telephone_number": "815-288-2251",
            "fax_number": "815-288-6821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXON PEOPLES HOME FUND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATION LONG TERM CARE",
        "authorized_official_telephone_number": "815-288-2251",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS MS LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0018176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dixon Dialysis Center, LLC
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• Dixon Healthcare & Rehabilitation Center
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• Dixon Optometric Center, Inc.
• Dixon Physical Therapy, LLC
• Dixon Usd 170
• Sarah Dodson
• Kristin Marie Dolieslager
• Mameyan Donzo, MD

• Skilled Nursing Facility in Dixon, IL
• Providers in Dixon, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.