Organization Active NPI

Western Nursing & Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Ballwin, MO
National Provider Identifier
1720317514
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WESTERN NURSING & REHABILITATION CENTER LLC
Doing business as
Wildwood Nursing & Rehabilitation Center
Practice address
1441 Charic Dr
Ballwin, MO 63021-2001
Phone
(636) 394-2522
Fax
(636) 394-8096
NPI assigned
Dec 8, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

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

Authorized official

Name
Mr. Robert G Hedges
Title
Managing Member of LLC
Phone
(217) 528-2244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1441 Charic Dr
Ballwin, MO 63021-2001

Mailing address

1625 S 6TH St
Springfield, IL 62703-2828
Phone (217) 528-2244

Other names 1

  • Wildwood Nursing & Rehabilitation Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267401600000",
    "number": "1720317514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032828",
            "telephone_number": "217-528-2244",
            "fax_number": "217-528-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 CHARIC DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630212001",
            "telephone_number": "636-394-2522",
            "fax_number": "636-394-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-08",
        "last_updated": "2010-03-01",
        "status": "A",
        "authorized_official_last_name": "HEDGES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING MEMBER OF LLC",
        "authorized_official_telephone_number": "217-528-2244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildwood Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; 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.