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Swedishamerican Hospital

Organization Active NPI Home Health Agency · Rockford, IL

NPI 1255439774 · NPPES record last updated Feb 6, 2015

Key facts

NPI
1255439774
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
1003169 (IL)
Legal business name
SWEDISHAMERICAN HOSPITAL
Practice address
2550 Charles St
Rockford, IL 61108-1673
Phone
(779) 696-7550
Fax
(815) 391-7501
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Ms. Ann M Gantzer, PHD
Title
Vice President of Patient Services
Phone
(815) 961-2030

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 386

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 386

Affiliated clinicians 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Home health agency

Listed as
Swedishamerican HH Care Med S CCN 147448
Overall star rating
★★★☆☆ 3 of 5
Ownership
Non-Profit
Certified
Mar 25, 1986
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Home health agency certification: CCN 147448

Legal name
SWEDISHAMERICAN HOSPITAL
Doing business as
SWEDISHAMERICAN HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 25, 1986
Last certification
Jan 7, 2017
Ownership / control type
Non-Profit
Organization structure
Corporation · Non-profit
Enrollment address
2550 Charles St
Rockford, IL 61108-1673
HHA Branch

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Allen D Williams
Individual 		Corporate Director
Board Member		 Jan 13, 2010
Justin Franklin
Individual 		Corporate Director
Board Member		 Jul 1, 2024
K Edward Copeland
Individual 		Corporate Director
Board Member		 Jul 1, 2024
Marco Lenis
Individual 		Corporate Director
Board Member		 Jan 13, 2010
Peter D Newcomer
Individual 		Corporate Director
Board Member		 Jul 1, 2020
Dan Ross
Individual 		Corporate Director
Board Member		 Jun 1, 2011
Patricia a Dewane
Individual 		Corporate Officer
VP Finance		 Jan 15, 2015
Corporate Director
Board Member		 Jan 15, 2015
W-2 Managing Employee
VP Finance		 Jan 15, 2015
Kathleen M Kelly
Individual 		Corporate Director
Board Member		 Jan 23, 2017
Carey M Gehl
Individual 		Corporate Director
Board Member		 Sep 25, 2023
Anqunette Parham
Individual 		Corporate Director
Board Member		 Oct 4, 2018
Michael Broski
Individual 		Corporate Director
Board Member		 Sep 1, 2015
Swedish American Health System Corporation
Organization · Rockford, IL
Non-profit 		5% Or Greater Direct Ownership Interest Mar 31, 1982 100%
Jeffrey Kaney
Individual 		Corporate Director
Board Member		 May 1, 2013
Travis D Andersen
Individual 		Corporate Officer
Ceo		 Oct 18, 2021
Corporate Director
Ceo		 Oct 18, 2021
W-2 Managing Employee
Ceo		 Oct 18, 2021
Pamela Maher
Individual 		Corporate Director
Board Member		 Sep 26, 2023
Thomas Walsh
Individual 		Corporate Director
Board Member		 Jan 13, 2010
Jeffrey Hultman
Individual 		Corporate Director
Board Member		 Jan 23, 2017
Regional Division Inc
Organization · Madison, WI
Non-profit 		5% Or Greater Indirect Ownership Interest Apr 15, 2015 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100318000248 IL Part a Provider - Home Health Agency 5799698346 Practice locations: Rockford, IL

National Provider Directory

Tax ID family
HHM Radiation Oncology (44 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1003169 IL Yes

Addresses

Primary practice location

2550 Charles St
Rockford, IL 61108-1673

Mailing address

2550 Charles St
Rockford, IL 61108-1673
Phone (779) 696-7550

Other identifiers

IdentifierTypeStateIssuer
50309OtherILBLUE CROSS BLUE SHIELD

Other names

  • SwedishAmerican Home Health Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 6, 2015.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1255439774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 CHARLES ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081673",
            "telephone_number": "779-696-7550",
            "fax_number": "815-391-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 CHARLES ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611081673",
            "telephone_number": "779-696-7550",
            "fax_number": "815-391-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISHAMERICAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "GANTZER",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PATIENT SERVICES",
        "authorized_official_telephone_number": "815-961-2030",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1003169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50309",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SwedishAmerican Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

All providers in Rockford, IL · Home Health Agency in Illinois

Sources for this page

Verify at the official NPI Registry.