NPIMap

Organization Active NPI

CGH Medical Center

Doing business as CGH Home Nursing

  • Home Health Agency
  • Sterling, IL
National Provider Identifier
1871533828
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1006451 Issued in IL
Legal business name
CGH MEDICAL CENTER
Doing business as
CGH Home Nursing
Practice address
3010 E Lynn Blvd
Suite B
Sterling, IL 61081-1717
Phone
(815) 622-0836
NPI assigned
Jun 7, 2006
Last updated
Aug 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Ms. Denise Wooden, RN
Title
Director CGH Home Nursing
Phone
(815) 622-0836

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1006451 IL Primary

Addresses

Primary practice location

3010 E Lynn Blvd
Suite B
Sterling, IL 61081-1717

Mailing address

3010 E Lynn Blvd
Suite B
Sterling, IL 61081
Phone (815) 622-0836

Other identifiers 1

IdentifierTypeStateIssuer
05148OtherILBLUE CROSS

Other names 1

  • CGH HOME NURSING Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC / Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120220000386 IL Part A Provider - Home Health Agency 6103723267 Practice locations: Sterling, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871533828. Details of each certification follow.

Home health agency certification: CCN 147562

Legal name
CGH MEDICAL CENTER
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 5, 1994
Last certification
Sep 17, 2020
Ownership / control type
Government Operated
Organization structure
GovernmentNon-profit
Enrollment address
3010 E Lynn Blvd
# B
Sterling, IL 61081-1717

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
CGH Home NursingCCN 147562 · All quality measures
Overall star rating
2.5 of 5
Ownership
Government Operated
Certified
May 5, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
14D0882629CGH Home Nursing3010 E Lynn Blvd, Sterling, IL 61081Certificate of waiverFeb 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Jose P Libunao MD7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

3010 E Lynn Blvd
#B
Sterling, IL 61081
Phone (815) 622-0836

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Nancy Rasmussen Individual Corporate DirectorBoard Member Aug 5, 2008
Heather Sotelo Individual Corporate DirectorDirector Aug 13, 2012
Paul Steinke Individual Corporate DirectorCeo Jan 4, 2013
Shawn P Hanlon Individual Corporate Director Nov 21, 2013
John a Vonosdol Individual Corporate DirectorBoard Member Apr 2, 1991
CGH Medical Center Organization, Sterling, IL Non-profit 5% Or Greater Direct Ownership Interest Feb 28, 1994 100%
Andy R Moore Individual Corporate OfficerBoard Vice Chair Jul 1, 2008
Julie M Morse Individual W-2 Managing Employee Jan 1, 2025
Marcia Jones Individual Corporate DirectorBoard Member Jan 17, 2011

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
CGH Medical CenterSterling, IL, CCN 140043 Hospital 5% Or Greater Direct Ownership Interest Nov 14, 2007

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1871533828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 E LYNN BLVD",
            "address_2": "SUITE B",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "61081",
            "telephone_number": "815-622-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 E LYNN BLVD",
            "address_2": "SUITE B",
            "city": "STERLING",
            "state": "IL",
            "postal_code": "610811717",
            "telephone_number": "815-622-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CGH MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "WOODEN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR CGH HOME NURSING",
        "authorized_official_telephone_number": "815-622-0836",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1006451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "05148",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CGH HOME NURSING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sterling, IL

Sources for this page

Verify at the official NPI Registry.