NPIMap

Organization Active NPI

Friendship Home

  • Skilled Nursing Facility
  • Carlinville, IL
National Provider Identifier
1477915643
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0042846 Issued in IL
Legal business name
FRIENDSHIP HOME
Practice address
826 N High St
Carlinville, IL 62626-1165
Phone
(217) 854-9606
Fax
(217) 854-8126
NPI assigned
Mar 25, 2016
Last updated
Mar 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Authorized official

Name
Rachel Lea Steward
Title
Business Office Manager
Phone
(217) 854-9606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0042846 IL Primary

Addresses

Primary practice location

826 N High St
Carlinville, IL 62626-1165

Mailing address

826 N High St
Carlinville, IL 62626-1165
Phone (217) 854-9606

Other identifiers 1

IdentifierTypeStateIssuer
1558358804OtherILMEDICARE A & B

National Provider Directory

National Provider Directory
Tax ID family
Eagle Point Nursing and Rehab Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1477915643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 N HIGH ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261165",
            "telephone_number": "217-854-9606",
            "fax_number": "217-854-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 N HIGH ST",
            "city": "CARLINVILLE",
            "state": "IL",
            "postal_code": "626261165",
            "telephone_number": "217-854-9606",
            "fax_number": "217-854-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDSHIP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "STEWARD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "217-854-9606"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0042846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE A & B",
            "identifier": "1558358804",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlinville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.