Sunrise Manor of Virden Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0025841 Issued in IL

Legal business name

SUNRISE MANOR OF VIRDEN INC

Practice address

333 Wrightsman St
Virden, IL 62690-1355

Phone

(217) 965-4715

Fax

(217) 965-5530

NPI assigned

Oct 10, 2008

Organization subpart

No

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

Authorized official

Name

Jerry W Jennings

Title

Controller

Phone

(217) 787-8530

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1184876930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 W LAWRENCE AVE STE B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627041115",
            "telephone_number": "217-787-8530",
            "fax_number": "217-787-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WRIGHTSMAN ST",
            "city": "VIRDEN",
            "state": "IL",
            "postal_code": "626901355",
            "telephone_number": "217-965-4715",
            "fax_number": "217-965-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE MANOR OF VIRDEN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "217-787-8530"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0025841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Virden, IL
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.