NPIMap

Organization Active NPI

Katherine Shaw Bethea Hospital

Doing business as KSB Hospice

  • Community Based Hospice Care Agency
  • Dixon, IL
National Provider Identifier
1205031721
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2001576 Issued in IL
Legal business name
KATHERINE SHAW BETHEA HOSPITAL
Doing business as
KSB Hospice
Practice address
101 W 2ND St
Suite 203
Dixon, IL 61021-3076
Phone
(815) 284-5710
Fax
(815) 285-5893
NPI assigned
Jun 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Authorized official

Name
Mr. David Schreiner
Title
Coo
Phone
(815) 285-5834

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2001576 IL Primary

Addresses

Primary practice location

101 W 2ND St
Suite 203
Dixon, IL 61021-3076

Mailing address

101 W 2ND St
Suite 203
Dixon, IL 61021-3076
Phone (815) 284-5710

Other names 1

  • KSB Hospice Doing business as

National Provider Directory

National Provider Directory

Locations

101 W 2nd St
Ste 203
Dixon, IL 61021
Phone (815) 284-5710

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1205031721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "address_2": "SUITE 203",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213076",
            "telephone_number": "815-284-5710",
            "fax_number": "815-285-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "address_2": "SUITE 203",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213076",
            "telephone_number": "815-284-5710",
            "fax_number": "815-285-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHERINE SHAW BETHEA HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "SCHREINER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "815-285-5834",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2001576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KSB Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.