County of Randolph Nursing Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

0000497 Issued in IL

Legal business name

COUNTY OF RANDOLPH NURSING HOME

Practice address

312 W Belmont St
Sparta, IL 62286-1709

Phone

(618) 443-4351

Fax

(618) 443-2700

NPI assigned

Feb 6, 2007

Last updated

Aug 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Liz Dilday

Title

Administrator

Phone

(618) 443-4351

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881734416. Details of each certification follow.

• CCN 145406 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 145406

Legal name

COUNTY OF RANDOLPH NURSING HOME

Doing business as

RANDOLPH COUNTY CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Apr 1, 1980

Last certification

Apr 30, 2024

Beds

100

Ownership / control type

County

Organization structure

GovernmentNon-profit

Enrollment address

312 W Belmont St
Sparta, IL 62286-1709

Nursing home name

RANDOLPH COUNTY CARE CENTER

Listed as

Randolph County Care CenterCCN 145406 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Apr 1, 1980

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10055.0 residents per day on average

Penalties (3 years)

3Fines totaling $172,932

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 6

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

Owners & managing parties with NPI records 1

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

• Russell Coulter, MD

  • Family Medicine Physician
  • Sparta, IL
  • NPI 1548227606

  Adp of the SNF, W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Russell Coulter, MD

  • Family Medicine Physician
  • Sparta, IL
  • NPI 1548227606

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1881734416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 W BELMONT ST",
            "address_2": "P.O. BOX 358",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622861709",
            "telephone_number": "618-443-4351",
            "fax_number": "618-443-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 W BELMONT ST",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622861709",
            "telephone_number": "618-443-4351",
            "fax_number": "618-443-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RANDOLPH NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "DILDAY",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-443-4351"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "IL",
            "license": "0000497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000497",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comwell
• Comwell
• Comwell
• Comwell
• Russell Coulter, MD
• Kermit Cox, CRNA
• Nancy Ann Davison
• Deaconess Illinois Clinic, Inc (Deaconess Illinois Clinic)
• Deaconess Illinois Clinic, Inc (Deaconess Illinois Clinic)
• Deaconess Illinois Specialty Clinic, Inc. (Deaconess IL Specialty Broadway St)

• Nursing Facility/Intermediate Care Facility in Sparta, IL
• Providers in Sparta, IL by specialty
• Nursing Facility/Intermediate Care Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.