St. Marys Health Care Center Investors LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ST. MARYS HEALTH CARE CENTER INVESTORS LLC

Doing business as

Edwardsville Nursing and Rehabilitation Center

Practice address

401 Saint Marys Dr
Edwardsville, IL 62025-4276

Phone

(618) 692-1330

Fax

(618) 692-9478

NPI assigned

Nov 17, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Brian Knootz

Title

Administrator

Phone

(618) 692-1330

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Edwardsville Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380672000000",
    "number": "1558343301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SAINT MARYS DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620254276",
            "telephone_number": "618-692-1330",
            "fax_number": "618-692-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SAINT MARYS DR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620254276",
            "telephone_number": "618-692-1330",
            "fax_number": "618-692-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARYS HEALTH CARE CENTER INVESTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2013-10-02",
        "status": "A",
        "authorized_official_last_name": "KNOOTZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-692-1330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558343301",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edwardsville Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nancy C Spina
• Sportchiro, LLC
• Lynette Kathleen Sproull, CCC-SLP
• Melanie Spung
• St. John'S Healing Community Board
• St. Marys Health Care Center Investors LLC
• Stacey J. Beisel, LCPC, P.C.
• Staci R Young MD PC
• Molly June Stacks, OD
• Lindsey Nichole Staff

• 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 2, 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.