NPIMap

Organization Active NPI

Anderson Rehabilitation Institute, LLC

Doing business as Anderson Rehabilitation Institute

  • Rehabilitation Hospital
  • Edwardsville, IL
National Provider Identifier
1396338703
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
ANDERSON REHABILITATION INSTITUTE, LLC
Doing business as
Anderson Rehabilitation Institute
Practice address
3402 Anderson Healthcare Dr
Edwardsville, IL 62025-7712
Phone
(618) 791-5467
NPI assigned
Feb 17, 2021
Last updated
Feb 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Authorized official

Name
Melissa Newbold Welge
Title
Ceo
Phone
(618) 791-5467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X NU Primary

Addresses

Primary practice location

3402 Anderson Healthcare Dr
Edwardsville, IL 62025-7712

Mailing address

680 S 4TH St
Louisville, KY 40202-2407
Phone (502) 596-6505

Other names 1

  • Anderson Rehabilitation Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607001384 IL Part A Provider - Hospital 0749680155 Practice locations: Edwardsville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396338703. Details of each certification follow.

Hospital certification: CCN 143029

Legal name
ANDERSON REHABILITATION INSTITUTE, LLC
Doing business as
ANDERSON REHABILITATION INSTITUTE
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Aug 22, 2021
Last certification
Aug 22, 2021
Beds
34
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
3402 Anderson Healthcare Dr
Edwardsville, IL 62025-7712
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Anderson Rehabilitation InstituteCCN 143029 · All quality measures
Ownership
For profit
Certified
Aug 22, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Donna Flannery Individual Corporate DirectorBoard Member Jul 27, 2021
Lifepoint Rehab Blocker LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 31, 2022 40%
Melissa Newbold Welge Individual Corporate OfficerHospital Ceo Jul 27, 2021
Operational/Managerial ControlHospital Ceo Jul 27, 2021
CHC Management Services LLC Organization, Brentwood, TN Management services company Operational/Managerial Control Jul 27, 2021
Lifepoint Rehab LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 40%
DSB Acquisition LLC Organization, New York, NY LLC 5% Or Greater Indirect Ownership Interest Dec 23, 2021 40%
Brian Samberg Individual Corporate DirectorBoard Member Jul 27, 2021
Lifepoint Health Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Dec 23, 2021 40%
Michael M Marshall Individual Corporate DirectorBoard Member Jul 27, 2021
Marcus B Poppell Individual OtherVice President Dec 23, 2021
Mark Krassinger Individual Corporate DirectorBoard Member Aug 9, 2021
Anderson Hospital Organization, Maryville, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 27, 2021 60%
Keith a Page Individual Corporate DirectorBoard Member Jul 27, 2021
KND Irf Development 14, LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Direct Ownership Interest Jul 27, 2021 40%
Lisa Spencer Individual Corporate DirectorBoard Member Jul 27, 2021
Lifepoint Rehab Blocker Parent LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Dec 31, 2022 40%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 70

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 70

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1396338703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S 4TH ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022407",
            "telephone_number": "502-596-6505",
            "fax_number": "502-596-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 ANDERSON HEALTHCARE DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620257712",
            "telephone_number": "618-791-5467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON REHABILITATION INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "WELGE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "NEWBOLD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-791-5467"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Rehabilitation Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edwardsville, IL

Sources for this page

Verify at the official NPI Registry.