Organization Active NPI

Petersen Health Junction, LLC

  • Skilled Nursing Facility
  • Canton, IL
National Provider Identifier
1104882919
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0046094 Issued in IL
Legal business name
PETERSEN HEALTH JUNCTION, LLC
Practice address
129 S 1St Ave
Canton, IL 61520-2612
Phone
(309) 647-4327
Fax
(309) 647-4354
NPI assigned
Apr 21, 2006
Organization subpart
Yes
Parent organization
PETERSEN HEALTH CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Mark B. Petersen
Title
President
Phone
(309) 691-8113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0046094 IL Primary

Addresses

Primary practice location

129 S 1St Ave
Canton, IL 61520-2612

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113

Other identifiers 1

IdentifierTypeStateIssuer
37-1068286001MedicaidIL

Other names 1

  • Sunset Rehabilitation & Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141013001925 IL Part A Provider - Skilled Nursing Facility 7012137177 Practice locations: Canton, IL

Skilled nursing facility certification: CCN 146016

Legal name
PETERSEN HEALTH JUNCTION LLC
Doing business as
SUNSET REHABILITATION & HEALTH CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 7, 2002
Last certification
Nov 21, 2024
Beds
115
Ownership / control type
Corporation
Multi-facility organization
Petersen Healthcare
Organization structure
LLCProprietary
Incorporated
Feb 1, 2013 in IL
Enrollment address
129S 1St Ave
Canton, IL 61520-2612

Care Compare: Nursing home

Medicare Care Compare
Listed as
Sunset Rehabilitation and Health CareCCN 146016
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 7, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11575.7 residents per day on average
Penalties (3 years)
4Fines totaling $518,295

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Petersen Health Care Inc

Locations

4656 W Kimberly Rd
Davenport, IA 52806
Phone (563) 391-5150

120 S Canton 1St Ave
Canton, IL 61614

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark B Petersen Individual 5% Or Greater Indirect Ownership Interest Aug 12, 2003 99%
Corporate OfficerPresident Aug 12, 2003 99%
Operational/Managerial ControlPresident Aug 12, 2003 99%
Michelle Hansmeyer Individual W-2 Managing EmployeeAdministrator Sep 15, 2014

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1104882919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 S 1ST AVE",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202612",
            "telephone_number": "309-647-4327",
            "fax_number": "309-647-4354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN HEALTH JUNCTION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PETERSEN HEALTH CARE, INC.",
        "enumeration_date": "2006-04-21",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37-1068286001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunset Rehabilitation & Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, IL

Sources for this page

Verify at the official NPI Registry.