NPIMap

Organization Active NPI

Marigold Hco LLC

  • Skilled Nursing Facility
  • Galesburg, IL
National Provider Identifier
1861670176
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0031245 Issued in IL
Legal business name
MARIGOLD HCO LLC
Practice address
275 E Carl Sandburg Dr
Galesburg, IL 61401-1249
Phone
(309) 344-1121
NPI assigned
Feb 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Stephanie Redburn
Title
Revenue Cycle Compliance Auditor
Phone
(816) 444-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0031245 IL Primary

Addresses

Primary practice location

275 E Carl Sandburg Dr
Galesburg, IL 61401-1249

Mailing address

275 E Carl Sandburg Dr
Galesburg, IL 61401-1249
Phone (309) 344-1151

Other names 1

  • Marigold Rehabilitation & Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200204002969 IL Part A Provider - Skilled Nursing Facility 8820424104 1 other NPI on this enrollment
Practice locations: Galesburg, IL

Skilled nursing facility certification: CCN 145446

Legal name
MARIGOLD HCO, LLC
Doing business as
MARIGOLD REHABILITATION & HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 2, 1982
Last certification
Aug 22, 2024
Beds
172
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
May 29, 2019 in IL
Enrollment address
275 E Carl Sandburg Dr
Galesburg, IL 61401-1249

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Marigold Rehabilitation and Health Care CenterCCN 145446
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 2, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
17279.4 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
7Fines totaling $517,260

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Mark B Petersen Individual 5% Or Greater Indirect Ownership InterestOfficer Oct 31, 2019 100%
Corporate OfficerOfficer Oct 31, 2019
Ethel Logue Individual W-2 Managing EmployeeAdministrator Jul 1, 2019
XCH, LLC Organization, Peoria, IL Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Oct 31, 2019 99%

Facilities with the same owner 2

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

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1861670176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E CARL SANDBURG DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011249",
            "telephone_number": "309-344-1151",
            "fax_number": "816-276-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E CARL SANDBURG DR",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011249",
            "telephone_number": "309-344-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIGOLD HCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "REDBURN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "REVENUE CYCLE COMPLIANCE AUDITOR",
        "authorized_official_telephone_number": "816-444-0900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0031245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marigold Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marigold Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.