Swansea Hco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0044404 Issued in IL

Legal business name

SWANSEA HCO, LLC

Practice address

1405 N 2ND St
Swansea, IL 62226-4213

Phone

(618) 233-6625

Fax

(618) 233-5858

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Mark B. Petersen

Title

Manager

Phone

(309) 689-5880

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Seansea Rehabilitation & Health Care Center Doing business as

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1598864654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N 2ND ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622264213",
            "telephone_number": "618-233-6625",
            "fax_number": "618-233-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWANSEA HCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-689-5880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0044404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "743055934017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seansea Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seansea Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy Elizabeth Stratman, PHARMD
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• Swansea Medical Group LTD
• Diane S Sweeney, PT
• Leann Christine Sweeney
• Sycamore Village LLC
• The Brown Clinic P.C.

• Skilled Nursing Facility in Swansea, IL
• Providers in Swansea, 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 Sep 11, 2020; 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.