NPIMap

Organization Active NPI

Petersen Health Operations, LLC

Doing business as Timbercreek Rehabilitation & Health Care

  • Skilled Nursing Facility
  • Pekin, IL
National Provider Identifier
1346340569
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0047522 Issued in IL
Legal business name
PETERSEN HEALTH OPERATIONS, LLC
Doing business as
Timbercreek Rehabilitation & Health Care
Practice address
2220 State St
Pekin, IL 61554-3937
Phone
(309) 347-1110
Fax
(309) 347-2135
NPI assigned
Sep 25, 2006
Last updated
Jan 19, 2022By the provider in NPPES
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
Skilled Nursing Facility 314000000X 0047522 IL Primary

Addresses

Primary practice location

2220 State St
Pekin, IL 61554-3937

Mailing address

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

Other names 1

  • Timbercreek Rehabilitation & Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060119000744 IL Part A Provider - Skilled Nursing Facility 8921020470 Practice locations: Pekin, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346340569. Details of each certification follow.

Skilled nursing facility certification: CCN 145275

Legal name
PETERSEN HEALTH OPERATIONS LLC
Doing business as
TIMBERCREEK REHAB & HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1974
Last certification
Aug 7, 2024
Beds
202
Ownership / control type
Corporation
Multi-facility organization
Peterson HC LLC
Organization structure
LLCProprietary
Incorporated
Jul 29, 2005 in IL
Enrollment address
2220 State St
Pekin, IL 61554-3937

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
Timbercreek Rehab and Health Care CenterCCN 145275 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
20289.0 residents per day on average
Special focus status
SFF Candidate
Penalties (3 years)
10Fines totaling $260,624

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 Sep 30, 2005
Corporate DirectorOfficer Jan 24, 2006
Jeremy Woodle Individual Operational/Managerial Control Jun 1, 2018

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

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": "1346340569",
    "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": "2220 STATE ST",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543937",
            "telephone_number": "309-347-1110",
            "fax_number": "309-347-2135"
        }
    ],
    "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0047522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timbercreek Rehabilitation & Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pekin, IL

Sources for this page

Verify at the official NPI Registry.