Active NPI
Marigold Hco LLC
Doing business as Marigold Rehabilitation & Health Care Center
- Skilled Nursing Facility
- Galesburg, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MARIGOLD HCO LLC
- Doing business as
- Marigold Rehabilitation & Health Care Center
- Practice address
- 275 E Carl Sandburg Dr
Galesburg, IL 61401-1249 - Phone
- (309) 344-1151
- NPI assigned
- Dec 23, 2019
- Last updated
- Dec 23, 2019
- 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
- Marikay Snyder
- Title
- General Counsel
- Phone
- (309) 689-5880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
275 E Carl Sandburg Dr
Galesburg, IL 61401-1249
Mailing address
830 W Trailcreek Dr
Peoria, IL 61614-1862
Other names 1
- Marigold Rehabilitation & Health Care Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200204002969 | IL | Part A Provider - Skilled Nursing Facility | 8820424104 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Galesburg, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1386283216. Details of each certification follow.
Skilled nursing facility certification: CCN 145446
- Legal name
- MARIGOLD HCO, LLC
- Doing business as
- MARIGOLD REHABILITATION & HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 2, 1982
- Last certification
- Aug 22, 2024
- Beds
- 172
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Incorporated
- May 29, 2019 in IL
- Enrollment address
- 275 E Carl Sandburg Dr
Galesburg, IL 61401-1249
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Marigold Rehabilitation & Health Care Center
- Skilled Nursing Facility
- Galesburg, IL
- NPI 1861670176
O20200204002969
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Marigold Rehabilitation and Health Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 2, 1982
- Medicare certification status
- Active
- Certified beds
- 172
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 7
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Mark B Petersen | 5% Or Greater Indirect Ownership Interest | Oct 31, 2019 | 100% |
| Corporate Officer | Oct 31, 2019 | ||
| Ethel Logue | W-2 Managing Employee | Jul 1, 2019 | |
| XCH, LLC | 5% Or Greater Direct Ownership Interest | Oct 31, 2019 | 99% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577059200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1577059200000",
"number": "1386283216",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 E CARL SANDBURG DR",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614011249",
"telephone_number": "309-344-1151"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARIGOLD HCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-12-23",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A",
"authorized_official_last_name": "SNYDER",
"authorized_official_first_name": "MARIKAY",
"authorized_official_title_or_position": "GENERAL COUNSEL",
"authorized_official_telephone_number": "309-689-5880"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Marigold Rehabilitation & Health Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Galesburg, IL
- Jennifer Main, MD
- Cheryl Majeske, MHP
- Julie A Maner Stevenson, APRN, CNP
- Cynthia Perez Mangubat, MD
- Sharon L Marguglio, APRN, CNP
- Marigold Hco LLC (Marigold Rehabilitation & Health Care Center)
- Marigold Rehabilitation & Health Care Center LLC
- Diana Martin, SLP
- Angi Martinprudent, AUDIOLOGIST
- Carolyn Marty, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.