Duquoin Nursing & Rehabilitation Center, LLC
Organization Active NPI Skilled Nursing Facility · Du Quoin, IL
NPI 1982143772 · NPPES record last updated Feb 14, 2017
Key facts
- NPI
- 1982143772
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- DUQUOIN NURSING & REHABILITATION CENTER, LLC
- Practice address
- 514 E Jackson St
Du Quoin, IL 62832-2427 - Phone
- (618) 542-4731
- Fax
- (618) 542-2651
- NPI assigned
- Feb 14, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Scott E. Stout
- Title
- Manager
- Phone
- (618) 713-5284
Corporate family (same tax ID) 1
Facilities with the same owner 12
Affiliated clinicians 1
-
Robert J Davidson, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Duquoin Nursing & Rehab
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 72 · 47.2 residents per day on average
- Chain
- WLC Management Firm
- Penalties (3 years)
- 2 · fines totaling $17,069
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145008
- Legal name
- DUQUOIN NURSING & REHABILITATION CENTER LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Aug 30, 2024
- Beds
- 72
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- WLC Managment Firm
- Organization structure
- LLC · Proprietary
- Incorporated
- Jan 31, 2017 in IL
- Enrollment address
- 514 E Jackson St
Du Quoin, IL 62832-2427 - Nursing home name
- DUQUOIN NURSING & REHAB
- Affiliated entity
- WLC MANAGEMENT FIRM
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Scott E Stout |
5% Or Greater Indirect Ownership Interest | Mar 1, 2017 | 100% |
| Corporate Officer |
Mar 1, 2017 | ||
| Operational/Managerial Control |
Mar 1, 2017 | ||
| WLC Management Firm LLC |
5% Or Greater Direct Ownership Interest | Mar 1, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170426001146 | IL | Part a Provider - Skilled Nursing Facility | 5799062949 | Practice locations: Du Quoin, IL |
National Provider Directory
- Tax ID family
- Duquoin Nursing Rehab Ctr
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
514 E Jackson St
Du Quoin, IL 62832-2427
Mailing address
514 E Jackson St
Du Quoin, IL 62832-2427
Phone (618) 542-4731
Other providers in Du Quoin, IL
- Du Quoin Community Unit School
- Michelle Marie Dudek
- Duquoin Chiropractic Center
- Duquoin Dental Associates, LTD.
- Duquoin Nursing & Rehabilitation
- Carol Easton
- Robert Dick Eaton
- Susan Eileen Engelhardt
- Fair Acres Nursing Home Inc
- Fair Acres Nursing Home Inc
All providers in Du Quoin, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.