NPIMap

Organization Active NPI

J & J Maupin Group Homes Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Decatur, IL
National Provider Identifier
1740404896
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
0047290 Issued in IL
Legal business name
J & J MAUPIN GROUP HOMES INC.
Doing business as
North Kickapoo
Practice address
5310 E William Street Rd
Decatur, IL 62521-1874
Phone
(217) 422-6361
Fax
(217) 422-6365
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Jeremy Ray Maupin
Title
President
Phone
(217) 422-6361

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 0047290 IL Primary

Addresses

Primary practice location

5310 E William Street Rd
Decatur, IL 62521-1874

Mailing address

5310 E William Street Rd
Decatur, IL 62521-1874
Phone (217) 422-6361

Other identifiers 1

IdentifierTypeStateIssuer
6011472MedicaidIL

Other names 1

  • North Kickapoo Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hickory Point Terrace2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740404896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E WILLIAM STREET RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625211874",
            "telephone_number": "217-422-6361",
            "fax_number": "217-422-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 E WILLIAM STREET RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625211874",
            "telephone_number": "217-422-6361",
            "fax_number": "217-422-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & J MAUPIN GROUP HOMES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAUPIN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-422-6361",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IL",
            "license": "0047290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6011472",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Kickapoo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.