NPIMap

Organization Active NPI

Trinity Visiting Nurse and Homecare Association

  • Community Based Hospice Care Agency
  • Moline, IL
National Provider Identifier
1124034426
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2001568 Issued in IL
Legal business name
TRINITY VISITING NURSE AND HOMECARE ASSOCIATION
Practice address
106 19TH Ave
Suite 101
Moline, IL 61265-3700
Phone
(309) 779-7600
Fax
(309) 779-7252
NPI assigned
Jul 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Authorized official

Name
Mr. Todd J Richard, PT
Title
Executive Director
Phone
(309) 779-7242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2001568 IL Primary

Addresses

Primary practice location

106 19TH Ave
Suite 101
Moline, IL 61265-3700

Mailing address

106 19 Avenue
Suite 101
Moline, IL 61265
Phone (309) 779-7600

Other identifiers 3

IdentifierTypeStateIssuer
96327OtherWELLMARK
9550OtherBLUE CROSS BLUE SHIELD
96326OtherWELLMARK I V

Other names 1

  • Trinity Pathway Hospice Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1124034426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 19 AVENUE",
            "address_2": "SUITE 101",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "309-779-7600",
            "fax_number": "309-779-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 19TH AVE",
            "address_2": "SUITE 101",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653700",
            "telephone_number": "309-779-7600",
            "fax_number": "309-779-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY VISITING NURSE AND HOMECARE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "309-779-7242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2001568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "96327",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9550",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK I V",
            "identifier": "96326",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Pathway Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; 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.