NPIMap

Organization Active NPI

St Pauls Senior Community LLC

Doing business as St. Paul's Home

  • Nursing Facility/Intermediate Care Facility
  • Belleville, IL
National Provider Identifier
1710973284
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
0013920 Issued in IL
Legal business name
ST PAULS SENIOR COMMUNITY LLC
Doing business as
St. Paul's Home
Practice address
1021 W E St
Belleville, IL 62220-1055
Phone
(618) 233-2095
Fax
(618) 233-2109
NPI assigned
Sep 21, 2005
Last updated
May 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Elizabeth Ann Papin
Title
Medicare Billing Specialist
Phone
(636) 222-0060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0013920 IL Primary

Addresses

Primary practice location

1021 W E St
Belleville, IL 62220-1055

Mailing address

1021 W E St
Belleville, IL 62220-1055
Phone (618) 233-2095

Other names 1

  • ST. PAUL'S HOME Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200409003211 IL Part A Provider - Skilled Nursing Facility 9133558232 Practice locations: Belleville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710973284. Details of each certification follow.

Skilled nursing facility certification: CCN 146122

Legal name
ST PAULS SENIOR COMMUNITY LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 23, 2008
Last certification
Jan 17, 2025
Beds
134 (108 certified)
Ownership / control type
Corporation
Multi-facility organization
Tutera Senior Living
Most recent change of ownership
Dec 1, 2019
Organization structure
LLCProprietary
Incorporated
Sep 3, 2019 in MO
Enrollment address
1021 W E St
Belleville, IL 62220-1055
Nursing home name
ST PAUL'S SENIOR COMMUNITY
Affiliated entity
TUTERA SENIOR LIVING & HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
St Paul's Senior CommunityCCN 146122 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 23, 2008
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10899.5 residents per day on average
Chain
Tutera Senior Living & Health Care25 facilities in the chain
Penalties (3 years)
6Fines totaling $227,658

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amy Merritt Individual W-2 Managing EmployeeAdministrator Dec 1, 2019 5%
Tutera Investments, LLC Organization, Kansas City, MO LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2019 40%
Jeff Gannon Individual Corporate OfficerVP of Revenue Cycle Dec 1, 2019 10%
Joseph C Tutera Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2019 30%
Kiley a Brooks Individual Corporate OfficerSr VP of Accounting/Oper. Finance Dec 1, 2019 15%
Ti-Belleville LLC Organization, Kansas City, MO Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Dec 1, 2019 100%

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1710973284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W E ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201055",
            "telephone_number": "618-233-2095",
            "fax_number": "618-233-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 W E ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201055",
            "telephone_number": "618-233-2095",
            "fax_number": "618-233-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PAULS SENIOR COMMUNITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "PAPIN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEDICARE BILLING SPECIALIST",
        "authorized_official_telephone_number": "636-222-0060"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0013920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. PAUL'S HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ST. PAUL'S HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.