County of Knox

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0010561 Issued in IL

Legal business name

COUNTY OF KNOX

Doing business as

Knox County Nursing Home

Practice address

800 N Market St
Knoxville, IL 61448-1096

Phone

(309) 289-2338

Fax

(309) 289-8255

NPI assigned

Oct 4, 2005

Last updated

Feb 13, 2023By 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

Jodi Ann Mines, LNHA

Title

Administrator

Phone

(309) 289-2338

Specialties & licenses 1

Addresses

Other names 1

• Knox County Nursing Home Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326035304. Details of each certification follow.

• CCN 145697 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 145697

Legal name

COUNTY OF KNOX

Doing business as

KNOX COUNTY NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 1, 1991

Last certification

Aug 16, 2024

Beds

169

Ownership / control type

County

Organization structure

OtherNon-profit

Enrollment address

800 N Market St
Knoxville, IL 61448-1096

Nursing home name

KNOX COUNTY NURSING HOME

Other NPIs with the same Medicare PAC ID 1

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

• County of Knox

  dba Knox County Health Department

  • Public Health or Welfare Agency
  • Galesburg, IL
  • NPI 1205944394

  4981725959

  Same PAC ID

Listed as

Knox County Nursing HomeCCN 145697 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Sep 1, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

169104.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

County of Knox3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• County of Knox

  dba Knox County Health Department

  • Public Health or Welfare Agency
  • Galesburg, IL
  • NPI 1205944394
  NPD tax ID
• Knox County Nursing Home

  • Skilled Nursing Facility
  • Knoxville, IL
  • NPI 1033354725
  NPD tax ID

Locations

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.

Owners & managing parties with NPI records 2

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

• Michael A Ahearn, MD

  • Family Medicine Physician
  • Kewanee, IL
  • NPI 1184687717

  Adp of the SNF

  CMS ownership
• County of Knox

  dba Knox County Health Department

  • Public Health or Welfare Agency
  • Galesburg, IL
  • NPI 1205944394

  Adp of the SNF

  CMS ownership

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Knox Community Health Center NFP

  • Federally Qualified Health Center (FQHC)
  • Galesburg, IL
  • NPI 1649526773

  5% Or Greater Direct Ownership Interest, Other

  CMS ownership

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• County of Knox

  dba Knox County Health Department

  • Public Health or Welfare Agency
  • Galesburg, IL
  • NPI 1205944394
  NPPES parent name

Affiliated clinicians 2

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

• Michael A Ahearn, MD

  • Family Medicine Physician
  • Kewanee, IL
  • NPI 1184687717

  Nursing home

  Care Compare affiliation
• Chad Lampe, MD

  • Family Medicine Physician
  • Canton, IL
  • NPI 1235659475

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1326035304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N MARKET ST",
            "city": "KNOXVILLE",
            "state": "IL",
            "postal_code": "614481096",
            "telephone_number": "309-289-2338",
            "fax_number": "309-289-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MARKET ST",
            "city": "KNOXVILLE",
            "state": "IL",
            "postal_code": "614481096",
            "telephone_number": "309-289-2338",
            "fax_number": "309-289-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF KNOX",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "MINES",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-289-2338",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0010561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knox County Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marcus Bailey
• Everett Brokaw, DMD
• County of Knox Knoxville Com Unit School Dist 202
• Annabelle Dayola-Ledford, APN
• East Belmont Dental
• Victoria Ann Fry
• Jinal Gala, M.S CFY-SLP

• Skilled Nursing Facility in Knoxville, IL
• Providers in Knoxville, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.

Verify at the official NPI Registry.