Westside Hco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WESTSIDE HCO, LLC

Practice address

601 N Columbia St
West Frankfort, IL 62896-1859

Phone

(618) 932-2109

NPI assigned

Feb 17, 2020

Organization subpart

No

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

Authorized official

Name

Mark B. Petersen

Title

Manager

Phone

(309) 691-8113

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1437782612",
    "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": "309-689-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N COLUMBIA ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961859",
            "telephone_number": "618-932-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE HCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie Jo Wells
• West Frankfort Cu Dist 168
• West Frankfort Family Care LLC
• Valerie West
• Beth Westell, O.D.
• Westside Hco, LLC
• Krysten Taylor Whitehead, APRN FNP-C
• Tamonte Whitelow
• Kelley Whitener
• Johann Wichmann, M.S.ED

• Skilled Nursing Facility in West Frankfort, IL
• Providers in West Frankfort, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.