Ridgway Rehabilitation and Nursing Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0040782 Issued in IL

Legal business name

RIDGWAY REHABILITATION AND NURSING CENTER, LLC

Practice address

900 W Race St
Ridgway, IL 62979-1150

Phone

(618) 272-8831

Fax

(618) 272-3041

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven Blisko

Title

C.F.O

Phone

(708) 236-0000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Willow of Ridgway Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erin M Krikie, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eldorado, IL
  • NPI 1447618897
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1336244151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD",
            "address_2": "SUITE 310",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772269",
            "telephone_number": "708-236-0000",
            "fax_number": "708-236-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W RACE ST",
            "city": "RIDGWAY",
            "state": "IL",
            "postal_code": "629791150",
            "telephone_number": "618-272-8831",
            "fax_number": "618-272-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGWAY REHABILITATION AND NURSING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "BLISKO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "C.F.O",
        "authorized_official_telephone_number": "708-236-0000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0040782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY ID",
            "identifier": "6007975",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Willow of Ridgway",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gallatin Manor LLC
• James Austin Koester
• Sarah Elizabeth Lawler, COTA/L
• Med Contract, Inc.
• PRN Pharmacies LTD
• Andrea Lyn Shaw
• Samuel Earl Shearer, R.PH., BCGP

• All providers in Ridgway, IL
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.