Southgate Health Care Center, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0017996 Issued in IL

Legal business name

SOUTHGATE HEALTH CARE CENTER, INC

Practice address

900 E 9TH St
Metropolis, IL 62960-2700

Phone

(618) 524-2683

Fax

(618) 524-3048

NPI assigned

Oct 12, 2005

Last updated

Jan 27, 2012By 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

Mrs. Rebekah Mahoney

Title

Administrator

Phone

(618) 524-2683

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710975842. Details of each certification follow.

• CCN 145386 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 145386

Legal name

SOUTHGATE HEALTH CARE CENTER, INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Aug 1, 1979

Last certification

Apr 18, 2025

Beds

140

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Jan 2, 1975 in IL

Enrollment address

900 East 9TH Street
Metropolis, IL 62960

Nursing home name

SOUTHGATE HEALTH CARE CENTER

Listed as

Southgate Health Care CenterCCN 145386 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 1, 1979

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

14091.9 residents per day on average

Penalties (3 years)

3Fines totaling $20,170

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Alex W Wright, M.D.

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1407296999

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alex W Wright, M.D.

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1407296999
  NPD (past)

Affiliated clinicians 3

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

• Jonathan E Walters, M.D.

  • Family Medicine Physician
  • Metropolis, IL
  • NPI 1427286038

  Nursing home

  Care Compare affiliation
• Mallory Renee Wittig, FNP

  • Family Nurse Practitioner
  • Metropolis, IL
  • NPI 1114285517

  Nursing home

  Care Compare affiliation
• Alex W Wright, M.D.

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1407296999

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1710975842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E 9TH ST",
            "address_2": "PO BOX 843",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629602700",
            "telephone_number": "618-524-2683",
            "fax_number": "618-524-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 9TH ST",
            "city": "METROPOLIS",
            "state": "IL",
            "postal_code": "629602700",
            "telephone_number": "618-524-2683",
            "fax_number": "618-524-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGATE HEALTH CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-524-2683",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0017996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50044",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Howard Shelton, D.M.D.
• Jennifer Shoemate, M.S., CCC-SLP
• Laura Dawn Sielbeck, MS/CCC-SLP
• Southern Illinois Nursing & Rehab LLC
• Southern Illinois Oxygen & Med Supplies
• Thomas Waldon Staton, M.D.
• Dylan Wade Street
• Ashley Dawn Suggs, APRN
• Tas of Illinois, LLC
• Phyllis Jean Thistlewood

• Skilled Nursing Facility in Metropolis, IL
• Providers in Metropolis, 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 Jan 27, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.