Unlimited Development Inc.
Organization Active NPI Skilled Nursing Facility · Pittsfield, IL
NPI 1992792147 · NPPES record last updated Jul 30, 2009
Key facts
- NPI
- 1992792147
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 47944 (IL)
- Legal business name
- UNLIMITED DEVELOPMENT INC.
- Practice address
- 610 Lowry Street
Pittsfield, IL 62363-1700 - Phone
- (217) 285-5200
- Fax
- (217) 285-5212
- NPI assigned
- Oct 3, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Ronald J Wilson
- Title
- Cfo
- Phone
- (309) 343-1550
Owners & managing parties with NPI records 1
-
Robert Wagner, M.D.
Owned or controlled facilities with NPI records 6
Other NPIs with the same Medicare PAC ID 9
Corporate family (same tax ID) 9
Member of 1
Affiliated clinicians 3
-
Sebastian Baginski, M.D.
-
Korhan B Raif, MD
Medicare Care Compare: Nursing home
- Listed as
- Pittsfield Manor
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 27, 1995
- Medicare certification status
- Active
- Certified beds
- 89 · 66.2 residents per day on average
- Chain
- Unlimited Development, Inc.
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 6 · fines totaling $212,564
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0665216 | Pittsfield Manor | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Skilled nursing facility certification: CCN 145837
- Legal name
- UNLIMITED DEVELOPMENT, INC
- Doing business as
- PITTSFIELD MANOR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 27, 1995
- Last certification
- Dec 9, 2024
- Beds
- 89
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 17, 1996 in IL
- Enrollment address
- 610 Lowry St
Pittsfield, IL 62363-1768 - Nursing home name
- PITTSFIELD MANOR
- Affiliated entity
- UNLIMITED DEVELOPMENT, INC.
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Audrey J Finke |
Corporate Officer |
Sep 5, 2018 | |
| Corporate Director |
Sep 5, 2018 | ||
| Jerry D Gilmore |
Corporate Director | Apr 26, 2006 | |
| Udi #9, LLC |
Operational/Managerial Control | Apr 26, 2006 | |
| Ronald J Wilson |
Corporate Officer |
Sep 5, 2018 | |
| David S Haney |
Corporate Director | Apr 26, 2006 | |
| Robert H Wagner |
Corporate Officer |
Sep 5, 2018 | |
| Corporate Director |
Apr 26, 2006 | ||
| Billye Jo Titus |
W-2 Managing Employee |
Sep 5, 2018 |
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Manor Court of Maryville |
Skilled nursing facility | 5% Or Greater Indirect Ownership Interest (100%) Operational/Managerial Control |
Jan 7, 2014 Jan 16, 2014 |
| Seminary Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2009 |
| Parkway Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2009 |
| Pekin Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest | Jun 1, 2009 |
| Centralia Manor |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest | Jun 1, 2009 |
| River Hills Village |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest (100%) | Jun 1, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090824000360 | IL | Part a Provider - Skilled Nursing Facility | 6901995513 | Practice locations: Pittsfield, IL |
National Provider Directory
- Tax ID family
- Unlimited Development Inc
Locations
610 Lowry St
Pittsfield, IL 62363
Phone (217) 285-5200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0047944 | IL | |
| Skilled Nursing Facility | 314000000X | 47944 | IL | Yes |
Addresses
Primary practice location
610 Lowry Street
Pittsfield, IL 62363-1700
Mailing address
610 Lowry Street
Pittsfield, IL 62363-1700
Phone (217) 285-5200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364560807001 | Medicaid | IL |
Other names
- UDI 9 Pittsfield Manor
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- Wal-Mart Stores, Inc
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- Walmart Inc.
- West Central Illinois Therapy & Sports Medicine Center, LLC
All providers in Pittsfield, 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 Jul 30, 2009. 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.