NPIMap

Organization Active NPI

Unlimited Development, Inc

Doing business as UDI 3 Shelbyville Manor

  • Skilled Nursing Facility
  • Shelbyville, IL
National Provider Identifier
1851387260
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1793553 Issued in IL
Legal business name
UNLIMITED DEVELOPMENT, INC
Doing business as
UDI 3 Shelbyville Manor
Practice address
1111 West North 12TH St
Shelbyville, IL 62565-9554
Phone
(217) 774-2111
Fax
(217) 774-2209
NPI assigned
Sep 21, 2005
Last updated
Nov 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Authorized official

Name
Mr. Ronald J Wilson
Title
Cfo
Phone
(309) 343-1550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1793553 IL Primary

Addresses

Primary practice location

1111 West North 12TH St
Shelbyville, IL 62565-9554

Mailing address

1111 West North 12TH St
Shelbyville, IL 62565-9554
Phone (217) 774-2111

Other identifiers 1

IdentifierTypeStateIssuer
201313843MedicaidIL

Other names 1

  • UDI 3 Shelbyville Manor Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090720000426 IL Part A Provider - Skilled Nursing Facility 6901995513 Practice locations: Shelbyville, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851387260. Details of each certification follow.

Skilled nursing facility certification: CCN 145441

Legal name
UNLIMITED DEVELOPMENT, INC
Doing business as
SHELBYVILLE MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1982
Last certification
Jun 7, 2024
Beds
109
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Unlimited Dev INC
Organization structure
CorporationNon-profit
Incorporated
Jul 28, 2005 in IL
Enrollment address
1111 West North 12TH St
Shelbyville, IL 62565-9554
Nursing home name
SHELBYVILLE MANOR
Affiliated entity
UNLIMITED DEVELOPMENT, INC.

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shelbyville ManorCCN 145441 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10985.1 residents per day on average
Chain
Unlimited Development, Inc.10 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
3Fines totaling $77,985

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Unlimited Development Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Audrey J Finke Individual Corporate DirectorDirector Aug 30, 2018
Jerry D Gilmore Individual Corporate Director Feb 2, 2006
Karen Dailey Individual W-2 Managing EmployeeAdministrator Feb 2, 2006
Udi #3, LLC Organization, Shelbyville, IL Operational/Managerial Control Feb 2, 2006
Ronald J Wilson Individual Corporate OfficerChief Financial Officer Aug 30, 2018
David S Haney Individual Corporate Director Feb 2, 2006
Robert H Wagner Individual Corporate OfficerPresident of Board of Directors Aug 30, 2018
Corporate DirectorDirector Feb 2, 2006

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Manor Court of MaryvilleMaryville, IL, CCN 145728 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%)
Operational/Managerial Control		 Jan 7, 2014
Jan 16, 2014
Seminary ManorGalesburg, IL, CCN 145598 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2009
Parkway ManorMarion, IL, CCN 145841 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2009
Pekin ManorPekin, IL, CCN 145597 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jun 1, 2009
Centralia ManorCentralia, IL, CCN 145666 Skilled nursing facility 5% Or Greater Direct Ownership Interest Jun 1, 2009
River Hills VillageKeokuk, IA, CCN 165396 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2010

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

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.

Affiliated clinicians 3

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": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1851387260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 WEST NORTH 12TH ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625659554",
            "telephone_number": "217-774-2111",
            "fax_number": "217-774-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 WEST NORTH 12TH ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625659554",
            "telephone_number": "217-774-2111",
            "fax_number": "217-774-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNLIMITED DEVELOPMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "309-343-1550",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "1793553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201313843",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UDI 3 Shelbyville Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelbyville, IL

Sources for this page

Verify at the official NPI Registry.