North Adams Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0020925 Issued in IL

Legal business name

NORTH ADAMS HOME INC

Practice address

2259 E 1100TH St
Mendon, IL 62351-2720

Phone

(217) 936-2137

Fax

(217) 936-3106

NPI assigned

Oct 7, 2005

Last updated

Dec 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robyn Johnson, RN, LNHA

Title

Administrator

Phone

(217) 936-2137

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1235127945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 E 1100TH ST",
            "city": "MENDON",
            "state": "IL",
            "postal_code": "623512720",
            "telephone_number": "217-936-2137",
            "fax_number": "217-936-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 E 1100TH ST",
            "city": "MENDON",
            "state": "IL",
            "postal_code": "623512720",
            "telephone_number": "217-936-2137",
            "fax_number": "217-936-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ADAMS HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "217-936-2137",
        "authorized_official_credential": "RN, LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0020925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020925",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana R. Knox, PMHNP
• Mendon Comm Unit School Dist 4
• Nicole Andrea Schaffnit, MS CCC-SLP
• Diane Kay Schrader, RD
• Debra Sue Tallcott, PT
• Addison Grace Zanger, M.S., CCC-SLP

• Skilled Nursing Facility in Mendon, IL
• Providers in Mendon, 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 Dec 19, 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.