NPIMap

Organization Active NPI

Charleston Hco LLC

Doing business as Charleston Rehab & Health Care Center

  • Skilled Nursing Facility
  • Charleston, IL
National Provider Identifier
1508956459
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0040311 Issued in IL
Legal business name
CHARLESTON HCO LLC
Doing business as
Charleston Rehab & Health Care Center
Practice address
716 18TH St
Charleston, IL 61920-2382
Phone
(217) 345-7054
Fax
(217) 348-1264
NPI assigned
Oct 13, 2006
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Stephanie Redburn
Title
Revenue Cycle Compliance Auditor
Phone
(816) 444-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0040311 IL Primary

Addresses

Primary practice location

716 18TH St
Charleston, IL 61920-2382

Mailing address

716 18TH St
Charleston, IL 61920-2382
Phone (217) 345-7054

Other identifiers 1

IdentifierTypeStateIssuer
270376016009MedicaidIL

Other names 1

  • Charleston Rehab & Health Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Flora Gardens Care Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1508956459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202382",
            "telephone_number": "217-345-7054",
            "fax_number": "816-276-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 18TH ST",
            "city": "CHARLESTON",
            "state": "IL",
            "postal_code": "619202382",
            "telephone_number": "217-345-7054",
            "fax_number": "217-348-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON HCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "REDBURN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "REVENUE CYCLE COMPLIANCE AUDITOR",
        "authorized_official_telephone_number": "816-444-0900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0040311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270376016009",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charleston Rehab & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Charleston Rehab & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.