NPIMap

Organization Active NPI

SSM Health Businesses

Doing business as SSM Health at Home Home Health Glen Carbon

  • Home Health Agency
  • Mount Vernon, IL
National Provider Identifier
1295798403
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1010902 Issued in IL
Legal business name
SSM HEALTH BUSINESSES
Doing business as
SSM Health at Home Home Health Glen Carbon
SSM Health at Home Home Health Mt Vernon
Practice address
1501 McPherson Ave
Mount Vernon, IL 62864-2831
Phone
(618) 899-1621
Fax
(618) 899-4744
NPI assigned
Apr 10, 2006
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Lisa Schweitzer, RN
Title
Vice President Patient Care Service
Phone
(608) 778-2146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1010902 IL Primary

Addresses

Primary practice location

1501 McPherson Ave
Mount Vernon, IL 62864-2831

Mailing address

2 Good Samaritan Way Ste 325
Mount Vernon, IL 62864-2486

Other names 2

  • SSM Health at Home Home Health Glen Carbon Doing business as
  • SSM Health at Home Home Health Mt Vernon Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081210000554 IL Part A Provider - Home Health Agency 8022107051 Practice locations: Mount Vernon, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295798403. Details of each certification follow.

Home health agency certification: CCN 147088

Legal name
SSM HEALTH BUSINESSES
Doing business as
SSM HEALTH AT HOME HOME HEALTH-ILLINOIS
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 4, 1968
Last certification
Mar 11, 2021
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
May 24, 1984 in MO
Enrollment address
1501 McPherson Ave
Mount Vernon, IL 62864-2831
HHA Branch

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
SSM Health at Home Health-IllinoisCCN 147088 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Nov 4, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Regional Health Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Lisa Schweitzer Individual Corporate OfficerSystem Dir Clinical Excellence Sep 2, 2022
Corporate DirectorSystem Dir Clinical Excellence Sep 2, 2022
Kari Krueger Individual Corporate OfficerRegional VP of Finance Sep 2, 2022
Corporate DirectorRegional VP of Finance Sep 2, 2022
W-2 Managing EmployeeReg VP-Finance Sep 2, 2022
Rebecca Shaw Individual Operational/Managerial ControlMGR RN Home Health and Hospice Jan 3, 2022
Steven Smoot Individual Corporate DirectorBoard Member, Coo Jul 30, 2018

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SSM Health at Home Home Health-WisconsinMadison, WI, CCN 527184 Home health agency 5% Or Greater Direct Ownership Interest (100%) Mar 29, 2024
SSM Health at Home Home Health- OklahomaOklahoma City, OK, CCN 377035A Home health agency Operational/Managerial Control Apr 1, 2000
SSM Health at Home Hospice IllinoisMount Vernon, IL, CCN 141530 Hospice Operational/Managerial Control Jan 1, 2008
SSM Health at Home Hospice-OklahomaOklahoma City, OK, CCN 371731 Hospice 5% Or Greater Direct Ownership Interest May 23, 1984

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1295798403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY STE 325",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MCPHERSON AVE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642831",
            "telephone_number": "618-899-1621",
            "fax_number": "618-899-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH BUSINESSES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "SCHWEITZER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VICE PRESIDENT PATIENT CARE SERVICE",
        "authorized_official_telephone_number": "608-778-2146",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SSM Health at Home Home Health Glen Carbon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health at Home Home Health Mt Vernon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.