Belleville Villas, LLC - Belleville Operation Series

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BELLEVILLE VILLAS, LLC - BELLEVILLE OPERATION SERIES

Practice address

4350 Frank Scott Pkwy W
Belleville, IL 62223-6810

Phone

(618) 744-0231

NPI assigned

Sep 27, 2024

Last updated

Sep 27, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BELLEVILLE VILLAS, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Randy Porter, CFO

Title

Chief Financial Officer

Phone

(217) 345-5022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1326866591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619204343",
            "telephone_number": "217-345-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 FRANK SCOTT PKWY W",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622236810",
            "telephone_number": "618-744-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVILLE VILLAS, LLC - BELLEVILLE OPERATION SERIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLEVILLE VILLAS, LLC",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "217-345-5022",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Belleville Urgent Care Walk-in Clinic
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• Brian Bendel
• Katherine Anne Benefield, MMS, PA-C

• Assisted Living Facility in Belleville, IL
• Providers in Belleville, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.