Presence Home Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010264 Issued in IL

Legal business name

PRESENCE HOME CARE

Doing business as

Presence Home Care - Urbana

Practice address

1501 Interstate Dr
Champaign, IL 61822-1006

Phone

(217) 355-4120

Fax

(217) 355-4121

NPI assigned

May 8, 2006

Last updated

Apr 12, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

PROVENA HEALTHAs reported in NPPES

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

Authorized official

Name

Michael Gordon

Title

Cfo

Phone

(708) 478-7911

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Presence Home Care - Urbana Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Presence Saint Joseph Hospital Chicago

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Presence Life Connections

  dba Ascension Living Saint Anne Place

  • Skilled Nursing Facility
  • Rockford, IL
  • NPI 1114913241

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Osf Healthcare System

  dba OSF Home Health

  • Home Health Agency
  • Champaign, IL
  • NPI 1134633746

  Sold to, 2018-02-28

  CMS change of ownership

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1659320869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9223 WEST ST FRANCIS ROAD",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604238334",
            "telephone_number": "815-806-2300",
            "fax_number": "815-806-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 INTERSTATE DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221006",
            "telephone_number": "217-355-4120",
            "fax_number": "217-355-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESENCE HOME CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVENA HEALTH",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "708-478-7911"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "50162",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4604853581004",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presence Home Care - Urbana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prairie Center Health Systems
• Vindha Prasad
• Chancie R Prater
• Dylan Patrick Prendergast
• Presence Central and Suburban Hospitals Network (Presence PRO Ambulance Service)
• Rachel Press, LCSW
• Ann Marie Preston, LPN
• Anna Jean Price, MSW, QMHP
• Marco L Price, MHP
• Richard Albert Price, CRC

• Home Health Agency in Champaign, IL
• Providers in Champaign, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.