Edwardsville Health Care Center Investors LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0046557 Issued in IL

Legal business name

EDWARDSVILLE HEALTH CARE CENTER INVESTORS LLC

Doing business as

University Nursing and Rehabilitation Center

Practice address

1095 University Dr
Edwardsville, IL 62025-3961

Phone

(618) 656-1081

Fax

(618) 656-7083

NPI assigned

Jul 26, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly A Wood

Title

Business Office Manager

Phone

(618) 656-1081

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• University Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1497755094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 UNIVERSITY DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253961",
            "telephone_number": "618-656-1081",
            "fax_number": "618-656-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 UNIVERSITY DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253961",
            "telephone_number": "618-656-1081",
            "fax_number": "618-656-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDSVILLE HEALTH CARE CENTER INVESTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "618-656-1081",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50288",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "71-00072",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Edwardsville, IL
• Providers in Edwardsville, 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 Oct 1, 2013; 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.