Goldwater Care Gibson City LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GOLDWATER CARE GIBSON CITY LLC

Doing business as

Goldwater Care Gibson City

Practice address

620 E 1St St
Gibson City, IL 60936-1822

Phone

(217) 784-4257

NPI assigned

Jun 6, 2023

Last updated

Sep 25, 2025By 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

Jennifer Spector

Title

VP of Revenue Cycle Management

Phone

(847) 262-3800

Specialties & licenses 1

Addresses

Other names 1

• Goldwater Care Gibson City Doing business as

Electronic endpoints 1

Tax ID family

Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Goldwater Care Gibson City LLC

  dba Goldwater Care Gibson City

  • Skilled Nursing Facility
  • Gibson City, IL
  • NPI 1821782525
  NPD tax ID

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1275227977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 W CHASE AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121605",
            "telephone_number": "847-262-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E 1ST ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361822",
            "telephone_number": "217-784-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDWATER CARE GIBSON CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "SPECTOR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "847-262-3800"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Goldwater Care Gibson City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gibson Community Hospital Association (Gibson City Clinic)
• Gibson Community Hospital Association (Gibson Area Hospital Endoscopy Center)
• Gibson Community Hospital Association (Gibson Area Internal Medicine)
• Gibson Community Hospital Association (Gibson Area Hospital ENT Clinic)
• Jonathan Shane Glickstein, MD
• Goldwater Care Gibson City LLC (Goldwater Care Gibson City)
• Christine Grundeman
• David John Hagan, MD
• Donna Ihsan Hakky, DMD
• Laura Elizabeth Hendrick, MSP, CF-SLP

• Durable Medical Equipment & Medical Supplies in Gibson City, IL
• Providers in Gibson City, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.