NPIMap

Organization Active NPI

Petersen Health Operations, LLC

  • Nursing Facility/Intermediate Care Facility
  • Benton, IL
National Provider Identifier
1316047681
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
0047407 Issued in IL
Legal business name
PETERSEN HEALTH OPERATIONS, LLC
Doing business as
Benton Rehabilitation & Health Care Center
Practice address
1409 N Main St
Benton, IL 62812-1918
Phone
(618) 435-2712
Fax
(618) 435-2105
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Mark B. Petersen
Title
President
Phone
(309) 691-8113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0047407 IL Primary

Addresses

Primary practice location

1409 N Main St
Benton, IL 62812-1918

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113

Other names 1

  • Benton Rehabilitation & Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071204000189 IL Part A Provider - Skilled Nursing Facility 8921020470 Practice locations: Benton, IL

Skilled nursing facility certification: CCN 146121

Legal name
PETERSEN HEALTH OPERATIONS LLC
Doing business as
BENTON REHABILITATION & HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Mar 5, 2008
Last certification
Apr 24, 2025
Beds
67
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Tutera Senior Living
Organization structure
LLCProprietary
Incorporated
Jul 29, 2005 in IL
Enrollment address
1409 N Main St
Benton, IL 62812-1918

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: Nursing home

Medicare Care Compare
Listed as
Benton Rehabilitation and Health Care CenterCCN 146121 · All quality measures
Overall star rating
1 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 5, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6739.2 residents per day on average
Penalties (3 years)
1Fines totaling $17,512

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Mark B Petersen Individual 5% Or Greater Direct Ownership InterestOfficer Aug 24, 2007 100%
Mary K Scharlemann Individual Operational/Managerial Control Sep 5, 2017

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1316047681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 N MAIN ST",
            "city": "BENTON",
            "state": "IL",
            "postal_code": "628121918",
            "telephone_number": "618-435-2712",
            "fax_number": "618-435-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN HEALTH OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0047407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benton Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Benton, IL

Sources for this page

Verify at the official NPI Registry.