NPIMap

Organization Active NPI

Eastview Terrace

  • Skilled Nursing Facility
  • Sullivan, IL
National Provider Identifier
1811984644
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0046060 Issued in IL
Legal business name
EASTVIEW TERRACE
Practice address
100 Eastview PL
Sullivan, IL 61951-1674
Phone
(217) 728-7367
Fax
(217) 728-2112
NPI assigned
Oct 6, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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
Janet Reedy, LPN
Title
Careplan Coordinator
Phone
(217) 728-7367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0046060 IL Primary

Addresses

Primary practice location

100 Eastview PL
Sullivan, IL 61951-1674

Mailing address

100 Eastview PL
Sullivan, IL 61951-1674
Phone (217) 728-7367

Other identifiers 1

IdentifierTypeStateIssuer
371346306007MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Petersen Health Care8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811984644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EASTVIEW PL",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619511674",
            "telephone_number": "217-728-7367",
            "fax_number": "217-728-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EASTVIEW PL",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619511674",
            "telephone_number": "217-728-7367",
            "fax_number": "217-728-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTVIEW TERRACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REEDY",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CAREPLAN COORDINATOR",
        "authorized_official_telephone_number": "217-728-7367",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371346306007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, 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.