NPIMap

Organization Active NPI

Swedishamerican Hospital

Doing business as SwedishAmerican Home Health Care

  • Home Health Agency
  • Rockford, IL
National Provider Identifier
1255439774
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1003169 Issued in IL
Legal business name
SWEDISHAMERICAN HOSPITAL
Doing business as
SwedishAmerican Home Health Care
Practice address
2550 Charles St
Rockford, IL 61108-1673
Phone
(779) 696-7550
Fax
(815) 391-7501
NPI assigned
Sep 20, 2006
Last updated
Feb 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Authorized official

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

Specialties & licenses 1

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

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 names 1

  • SwedishAmerican Home Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255439774. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
2550 Charles St
Rockford, IL 61108-1673
HHA Branch

Other NPIs with the same Medicare PAC ID 7

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Swedishamerican HH Care Med SCCN 147448 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Mar 25, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Northern Illinois Surgery44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Ownership & related parties

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 DirectorBoard Member Jan 13, 2010
Justin Franklin Individual Corporate DirectorBoard Member Jul 1, 2024
K Edward Copeland Individual Corporate DirectorBoard Member Jul 1, 2024
Marco Lenis Individual Corporate DirectorBoard Member Jan 13, 2010
Peter D Newcomer Individual Corporate DirectorBoard Member Jul 1, 2020
Dan Ross Individual Corporate DirectorBoard Member Jun 1, 2011
Patricia a Dewane Individual Corporate OfficerVP Finance Jan 15, 2015
Corporate DirectorBoard Member Jan 15, 2015
W-2 Managing EmployeeVP Finance Jan 15, 2015
Kathleen M Kelly Individual Corporate DirectorBoard Member Jan 23, 2017
Carey M Gehl Individual Corporate DirectorBoard Member Sep 25, 2023
Anqunette Parham Individual Corporate DirectorBoard Member Oct 4, 2018
Michael Broski Individual Corporate DirectorBoard 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 DirectorBoard Member May 1, 2013
Travis D Andersen Individual Corporate OfficerCeo Oct 18, 2021
Corporate DirectorCeo Oct 18, 2021
W-2 Managing EmployeeCeo Oct 18, 2021
Pamela Maher Individual Corporate DirectorBoard Member Sep 26, 2023
Thomas Walsh Individual Corporate DirectorBoard Member Jan 13, 2010
Jeffrey Hultman Individual Corporate DirectorBoard Member Jan 23, 2017
Regional Division Inc Organization, Madison, WI Non-profit 5% Or Greater Indirect Ownership Interest Apr 15, 2015 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SwedishAmerican Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.