NPIMap

Organization Active NPI

Wabash Senior Living & Rehabilitation LLC

  • Skilled Nursing Facility
  • Carmi, IL
National Provider Identifier
1902680069
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WABASH SENIOR LIVING & REHABILITATION LLC
Practice address
216 College Blvd
Carmi, IL 62821-1548
Phone
(618) 294-8699
Fax
(618) 294-8699
NPI assigned
Aug 21, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Scott E Stout, LNHANPI 1952874075
Title
Ceo/Owner
Phone
(618) 713-5284

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

216 College Blvd
Carmi, IL 62821-1548

Mailing address

35 S Vine St
Harrisburg, IL 62946-1738
Phone (618) 294-8696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240109004454 IL Part A Provider - Skilled Nursing Facility 4284085705 Practice locations: Carmi, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902680069. Details of each certification follow.

Skilled nursing facility certification: CCN 146019

Legal name
WABASH SENIOR LIVING & REHABILITATION LLC
Doing business as
WLC MANAGEMENT FIRM
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 21, 2001
Last certification
Apr 25, 2025
Beds
156
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Jul 31, 2023 in IL
Enrollment address
216 College Blvd
Carmi, IL 62821-1548
Nursing home name
WABASH SENIOR LIVING & REHAB
Affiliated entity
WLC MANAGEMENT FIRM

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wabash Senior Living & RehabCCN 146019 · 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
For profit - Limited Liability company
Certified
Dec 21, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
156104.9 residents per day on average
Chain
WLC Management Firm18 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $93,679

Processed by Care Compare on Aug 1, 2026.

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
14D0885882Wabash Senior Living & Rehabilitation LLC216 College Blvd, Carmi, IL 62821Certificate of waiverMay 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Scott E Stout Individual 5% Or Greater Direct Ownership InterestCeo Dec 1, 2023 100%
Corporate OfficerCeo Dec 1, 2023 100%
Operational/Managerial ControlCeo/Owner Dec 1, 2023 100%
WLC Management Firm LLC Organization, Harrisburg, IL LLC, Management services company, For-profit Operational/Managerial Control Dec 1, 2023 100%

Facilities with the same owner 4

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

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 1

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": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1902680069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S VINE ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629461738",
            "telephone_number": "618-294-8696",
            "fax_number": "618-294-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 COLLEGE BLVD",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211548",
            "telephone_number": "618-294-8699",
            "fax_number": "618-294-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABASH SENIOR LIVING & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "618-713-5284",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmi, IL

Sources for this page

Verify at the official NPI Registry.