NPIMap

Organization Active NPI

Fairview Rehabilitation & Healthcare LLC

  • Skilled Nursing Facility
  • Du Quoin, IL
National Provider Identifier
1730748575
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
FAIRVIEW REHABILITATION & HEALTHCARE LLC
Practice address
602 E Jackson St
Du Quoin, IL 62832-2429
Phone
(618) 542-3441
NPI assigned
Jun 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Authorized official

Name
Mr. Scott E Stout, LNHA
Title
Ceo
Phone
(618) 294-8696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

602 E Jackson St
Du Quoin, IL 62832-2429

Mailing address

215 E Locust St
Harrisburg, IL 62946-1504
Phone (618) 294-8696

Other identifiers 1

IdentifierTypeStateIssuer
37092391001MedicaidIL

Other names 1

  • Farview Rehabilitation & Healthcare Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Scott@WCLfirm.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190729000131 IL Part A Provider - Skilled Nursing Facility 7012243132 Practice locations: Du Quoin, IL

Skilled nursing facility certification: CCN 146032

Legal name
FAIRVIEW REHABILITATION & HEALTHCARE LLC
Doing business as
FAIRVIEW REHABILITATION & HEALTHCARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Aug 15, 2002
Last certification
May 16, 2024
Beds
76
Ownership / control type
Limited Liability Corporation
Multi-facility organization
WLC Managment Firm
Organization structure
LLCProprietary
Incorporated
Jun 3, 2019 in IL
Enrollment address
602 E Jackson St
Du Quoin, IL 62832-2429
Nursing home name
FAIRVIEW REHAB & HEALTHCARE
Affiliated entity
WLC MANAGEMENT FIRM

Care Compare: Nursing home

Medicare Care Compare
Listed as
Fairview Rehab & HealthcareCCN 146032
Overall star rating
3 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 15, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7656.5 residents per day on average
Chain
WLC Management Firm18 facilities in the chain
Penalties (3 years)
2Fines totaling $30,972

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2170709Fairview Rehabilitation & Healthcare602 E Jackson St, Du Quoin, IL 62832Certificate of waiverAug 15, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: scott@wclfirm.com

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Robert J Davidson Individual Contracted Managing EmployeeMD; Jan 1, 2021
Scott E Stout Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2019 100%
Operational/Managerial ControlCeo Jul 1, 2019 100%
Jodie Davies Individual W-2 Managing EmployeeAd; Jul 19, 2023 75%
WLC Management Firm LLC Organization, Harrisburg, IL LLC 5% Or Greater Direct Ownership Interest Jul 1, 2019 100%
Operational/Managerial Control Jul 1, 2019 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1559779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1730748575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E LOCUST ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629461504",
            "telephone_number": "618-294-8696",
            "fax_number": "618-294-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 E JACKSON ST",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628322429",
            "telephone_number": "618-542-3441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW REHABILITATION & HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-294-8696",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37092391001",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Scott@WCLfirm.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "602 E Jackson St",
            "city": "Du Quoin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628322429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Farview Rehabilitation & Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Du Quoin, IL

Sources for this page

Verify at the official NPI Registry.