NPIMap

Organization Active NPI

Monroe County

  • Skilled Nursing Facility
  • Waterloo, IL
National Provider Identifier
1548780828
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0047019 Issued in IL
Legal business name
MONROE COUNTY
Practice address
623 Hamacher St
Waterloo, IL 62298-1786
Phone
(618) 939-3488
Fax
(618) 939-5030
NPI assigned
Jun 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Elizabeth Marie Smith
Title
Business Office Manager
Phone
(618) 939-3488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0047019 IL Primary

Addresses

Primary practice location

623 Hamacher St
Waterloo, IL 62298-1786

Mailing address

623 Hamacher Street
Waterloo, IL 62298-1598
Phone (618) 939-3488

Other names 1

  • Oak Hill Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Monroe County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1548780828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 HAMACHER STREET",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981598",
            "telephone_number": "618-939-3488",
            "fax_number": "618-939-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 HAMACHER ST",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981786",
            "telephone_number": "618-939-3488",
            "fax_number": "618-939-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "618-939-3488",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0047019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Hill",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oak Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.