Pinckneyville Nursing & Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0052704 Issued in IL

Legal business name

PINCKNEYVILLE NURSING & REHABILITATION CENTER, LLC

Doing business as

Pinckneyville Nursing & Rehabilitation Center

Practice address

708 Virginia CT
Pinckneyville, IL 62274-1538

Phone

(618) 357-2493

Fax

(618) 357-3120

NPI assigned

Feb 3, 2014

Last updated

Feb 14, 2017By 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

Mr. Scott E Stout, LNHA

Title

Owner

Phone

(618) 252-6383

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pinckneyville Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1902229537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 VIRGINIA CT",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741538",
            "telephone_number": "618-357-2493",
            "fax_number": "618-357-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 VIRGINIA CT",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741538",
            "telephone_number": "618-357-2493",
            "fax_number": "618-357-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINCKNEYVILLE NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-03",
        "last_updated": "2017-02-14",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-252-6383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0052704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF PUBLIC HEALTH LICENSE NUMBER",
            "identifier": "0052704",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinckneyville Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Pinckneyville, IL
• Providers in Pinckneyville, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.