Cambridge House of Maryville

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

001 Issued in IL

Legal business name

CAMBRIDGE HOUSE OF MARYVILLE

Practice address

6960 State Route 162
Maryville, IL 62062-8532

Phone

(618) 288-2211

Fax

(618) 288-2299

NPI assigned

Jun 29, 2007

Last updated

Jul 21, 2022By 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

Ms. Pamela Jane Fellows, R.N.

Title

Administrator

Phone

(618) 288-2211

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1942407200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6960 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628532",
            "telephone_number": "618-288-2211",
            "fax_number": "618-288-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6960 STATE ROUTE 162",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628532",
            "telephone_number": "618-288-2211",
            "fax_number": "618-288-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE HOUSE OF MARYVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FELLOWS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-288-2211",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": "001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry J Burk, MD
• Cari A Burke, MS, CCC-SLP
• Katherine Anne Burnley, ANP-C
• Rachel Burns
• Jill C Butler, MS, CCC/SLP
• Gabriel Cardenas Jr., D.P.M.
• Hailey R. Carmody, OTR
• Monica Carroll, MS, CCC-SLP
• Maria Catalano, PA
• Gianna R Catanzaro

• Assisted Living Facility in Maryville, IL
• Providers in Maryville, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.