Greenbrier Lodge, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0044487 Issued in IL

Legal business name

GREENBRIER LODGE, INC.

Practice address

600 S. Maple Street
Piper City, IL 60959

Phone

(815) 686-2277

Fax

(815) 686-2812

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Craig L Ater

Title

Senior V.P. of Finance

Phone

(309) 828-4361

Specialties & licenses 1

Addresses

Other names 1

• Greenbrier Healthcare Center Doing business as

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184774465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S. MAPLE STREET",
            "city": "PIPER CITY",
            "state": "IL",
            "postal_code": "60959",
            "telephone_number": "815-686-2277",
            "fax_number": "815-686-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S. MAPLE STREET",
            "city": "PIPER CITY",
            "state": "IL",
            "postal_code": "60959",
            "telephone_number": "815-686-2277",
            "fax_number": "815-686-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIER LODGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ATER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR V.P. OF FINANCE",
        "authorized_official_telephone_number": "309-828-4361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0044487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenbrier Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Greenbrier Senior Living Community, LLC
• Piper Hco, LLC
• Piper Hco, LLC
• Miranda Leanne Rettell, PTA
• Jaqulyn Dianne Thomas, PTA

• Skilled Nursing Facility in Piper City, IL
• Providers in Piper City, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.