Canterbury Manor Nursing Center Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

CANTERBURY MANOR NURSING CENTER INC

Practice address

718 N Market St
Waterloo, IL 62298-1014

Phone

(618) 939-8565

Fax

(618) 939-3650

NPI assigned

Jul 14, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Diana S Kington

Title

President

Phone

(618) 549-8331

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1194724906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N MARKET ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981014",
            "telephone_number": "618-939-8565",
            "fax_number": "618-939-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N MARKET ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981014",
            "telephone_number": "618-939-8565",
            "fax_number": "618-939-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTERBURY MANOR NURSING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-14",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KINGTON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-549-8331",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald K. Burden, D.D.S.
• Jonathan Andrew Burkhart, BS
• Claire Burmester
• Lauren Cage, OTD, OTR/L
• Canterbury Manor Nursing Center
• Ashton Reese Carmichael
• Nathan Lee Caron, MHP
• Shani Cary, RSA
• Lea Chandrl, MHP
• Kimberly Chism, RSA

• All providers in Waterloo, IL
• Nursing Facility/Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.