NPIMap

Organization Active NPI

Granite City Illinois Hospital Company LLC

  • Rehabilitation Hospital Unit
  • Granite City, IL
National Provider Identifier
1083685887
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
1010199 Issued in IL
Legal business name
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC
Practice address
2100 Madison Ave
Granite City, IL 62040-4701
Phone
(618) 798-3000
Fax
(618) 798-3724
NPI assigned
Jan 30, 2006
Organization subpart
Yes
Parent organization
GRANITE CITY ILLINOIS HOSPITAL COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Randy Michael Cooper
Title
SVP Finance Operations/Ao
Phone
(615) 221-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 1010199 IL Primary

Addresses

Primary practice location

2100 Madison Ave
Granite City, IL 62040-4701

Mailing address

PO Box 503706
Saint Louis, MO 63150-3706

Other names 1

  • Gateway Regional Medical Center Doing business as

National Provider Directory

National Provider Directory
Part of
Gateway Regional Med

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1083685887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 503706",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631503706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404701",
            "telephone_number": "618-798-3000",
            "fax_number": "618-798-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SVP FINANCE OPERATIONS/AO",
        "authorized_official_telephone_number": "615-221-3840"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IL",
            "license": "1010199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gateway Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.