Active NPI
Morris Nursing, LLC
- Skilled Nursing Facility
- Morris, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MORRIS NURSING, LLC
- Practice address
- 1223 Edgewater Dr
Morris, IL 60450-2504 - Phone
- (815) 416-6500
- NPI assigned
- Jun 21, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Coglianese
- Title
- Authorized Official
- Phone
- (815) 416-6500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1223 Edgewater Dr
Morris, IL 60450-2504
Mailing address
7101 N Cicero Ave Ste 200
Lincolnwood, IL 60712-2112
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250123000897 | IL | Part A Provider - Skilled Nursing Facility | 1759815947 | Practice locations: Morris, IL |
Skilled nursing facility certification: CCN 146077
- Legal name
- MORRIS NURSING, LLC
- Doing business as
- SERENITY ESTATES OF MORRIS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 14, 2005
- Last certification
- Oct 11, 2024
- Beds
- 142
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 1223 Edgewater Dr
Morris, IL 60450-2504 - Nursing home name
- SERENITY ESTATES AT MORRIS
- Affiliated entity
- SERENITY ESTATES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Serenity Estates at Morris
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Feb 14, 2005
- Medicare certification status
- Active
- Certified beds
- 142
- Chain
- Serenity Estates
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| FNR Morris LLC | Adp of the SNF | Aug 1, 2024 | |
| Adp of the SNF | Aug 1, 2024 | ||
| Adp of the SNF | Aug 1, 2024 | ||
| Jennifer Daugherty | Operational/Managerial Control | Aug 1, 2024 | |
| Managing Control - Governing Body | Aug 1, 2024 | ||
| Adp of the SNF | Aug 1, 2024 | ||
| Direct Ownership Interest | Aug 1, 2024 | 50% | |
| Dmitry Godin | Adp of the SNF | Aug 1, 2024 | |
| Adp of the SNF | Jan 23, 2025 | ||
| GS Management LLC | Operational/Managerial Control | Aug 1, 2024 | |
| Adp of the SNF | Aug 1, 2024 | ||
| John Coglianese | Operational/Managerial Control | Sep 1, 2024 | |
| Managing Control - Governing Body | Aug 1, 2024 | ||
| Adp of the SNF | Aug 1, 2024 | ||
| Direct Ownership Interest | Aug 1, 2024 | 50% | |
| Peter Roumeliotis | Operational/Managerial Control | Aug 1, 2024 | |
| Adp of the SNF | Aug 1, 2024 | ||
| Suzanne D Day | Operational/Managerial Control | Aug 1, 2024 | |
| Adp of the SNF | Mar 11, 2025 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Morris, IL
- NPI 1942280326
Adp of the SNF, Operational/Managerial Control
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 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718928000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718928000000",
"number": "1295579506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7101 N CICERO AVE STE 200",
"city": "LINCOLNWOOD",
"state": "IL",
"postal_code": "607122112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1223 EDGEWATER DR",
"city": "MORRIS",
"state": "IL",
"postal_code": "604502504",
"telephone_number": "815-416-6500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MORRIS NURSING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-21",
"last_updated": "2024-06-21",
"certification_date": "2024-06-21",
"status": "A",
"authorized_official_last_name": "COGLIANESE",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "815-416-6500"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Morris, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.