Organization Active NPI

Au Well Care Home Inc

  • Skilled Nursing Facility
  • Maryville, IL
National Provider Identifier
1619719044
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
AU WELL CARE HOME INC
Practice address
152 Wilma Dr
Maryville, IL 62062-5435
Phone
(618) 344-7750
Fax
(618) 344-3520
NPI assigned
Jun 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Dr. Ahsan Usman, MDNPI 1215016571
Title
President
Phone
(618) 344-7750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

152 Wilma Dr
Maryville, IL 62062-5435

Mailing address

6 Indian Creek Lane
Frontenac, MO 63131
Phone (618) 344-7750

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1619719044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 INDIAN CREEK LANE",
            "city": "FRONTENAC",
            "state": "MO",
            "postal_code": "63131",
            "telephone_number": "618-344-7750",
            "fax_number": "618-344-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 WILMA DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625435",
            "telephone_number": "618-344-7750",
            "fax_number": "618-344-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AU WELL CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "USMAN",
        "authorized_official_first_name": "AHSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-344-7750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.