Decatur Skilled LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DECATUR SKILLED LLC

Practice address

180 W Imboden Dr
Decatur, IL 62521-5238

Phone

(217) 422-6464

NPI assigned

Oct 2, 2026

Last updated

Oct 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Kirby

Title

Manager

Phone

(619) 201-5888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1609780931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 AVENIDA DEL DIABLO",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920293112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 W IMBODEN DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625215238",
            "telephone_number": "217-422-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR SKILLED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "619-201-5888"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Decatur, IL
• Providers in Decatur, 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, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.