Active NPI
Jennings Terrace
- Nursing Facility/Intermediate Care Facility
- Aurora, IL
National Provider Identifier
1376706010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 0010371
- Legal business name
- JENNINGS TERRACE
- Practice address
- 275 S. Lasalle Street
Aurora, IL 60505 - Phone
- (630) 879-6947
- Fax
- (630) 879-6949
- NPI assigned
- Jul 2, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jomarie Silver
- Title
- Administrator
- Phone
- (630) 235-1013
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 0010371 | IL | Primary |
| Skilled Nursing Facility | 314000000X | 0010371 | IL | |
| Respite Care | 385H00000X | 0010371 | IL |
Addresses
Primary practice location
275 S. Lasalle Street
Aurora, IL 60505
Mailing address
275 S Lasalle Street
Aurora, IL 60505-4258
Phone (630) 897-6947
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060320000522 | IL | Part A Provider - Skilled Nursing Facility | 2466469234 | Practice locations: Aurora, IL |
Skilled nursing facility certification: CCN 146197
- Legal name
- JENNINGS TERRACE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 13, 2021
- Last certification
- Nov 21, 2024
- Beds
- 163 (60 certified)
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Mar 16, 1943 in IL
- Enrollment address
- 275 S Lasalle St
Aurora, IL 60505-5841 - Nursing home name
- JENNINGS TERRACE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Jennings Terrace
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Oct 13, 2021
- Medicare certification status
- Active
- Certified beds
- 60
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2195223 | Jennings Terrace | Certificate of waiver | Oct 6, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Duanne Kleckner | Corporate Director | Oct 28, 2020 | 50% |
| David M Underwood | Corporate Officer | Oct 28, 2020 | 10% |
| Jonathan Bieritz | Corporate Director | Jul 20, 2022 | 10% |
| Lynn Akers | Corporate Director | Oct 28, 2020 | 10% |
| Jim Brown | Corporate Director | Oct 28, 2020 | 10% |
| Jomarie Silver | Corporate Director | Apr 28, 2022 | |
| W-2 Managing Employee | Jun 29, 2022 | 100% | |
| Operational/Managerial Control | Apr 28, 2022 | 100% |
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": "1214956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1656460800000",
"number": "1376706010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 S LASALLE STREET",
"city": "AURORA",
"state": "IL",
"postal_code": "605054258",
"telephone_number": "630-897-6947",
"fax_number": "630-897-6949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 S. LASALLE STREET",
"city": "AURORA",
"state": "IL",
"postal_code": "60505",
"telephone_number": "630-879-6947",
"fax_number": "630-879-6949"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JENNINGS TERRACE",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-02",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A",
"authorized_official_last_name": "SILVER",
"authorized_official_first_name": "JOMARIE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "630-235-1013"
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "IL",
"license": "0010371",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IL",
"license": "0010371",
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "IL",
"license": "0010371",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.