STOCKTON HEALTHCARE AND REHAB, INC (NPI# 1013200153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013200153 |
| Entity Type | Organization |
| Organization Name | STOCKTON HEALTHCARE AND REHAB, INC |
| Practice Address |
501 E Front Ave Stockton IL 61085-1444 |
| Mailing Address |
2711 W Howard St Chicago IL 60645-1303 |
| Practice Telephone | 8159472215 |
| Practice Fax Number | 8159472027 |
| Mailing Telephone | 7733384400 |
| Mailing Fax Number | 7733384414 |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2011-06-28 |
| Authorized Official Name | JOSEPH BRANDMAN (C.O.O) |
| Authorized Official Telephone | 7733384400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0051268 | IL | Nursing & Custodial Care Facilities |
| Street Address |
501 E FRONT AVE |
| City | STOCKTON |
| State | IL |
| Zip Code | 61085-1444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194818385 | Jennifer Johnson | Physical Therapist | 501 E Front Ave, Stockton, IL 61085-1444 | 2006-10-02 |
| 1750905709 | Christina Brown | Physical Therapy Assistant | 501 E Front Ave, Stockton, IL 61085-1444 | 2020-06-05 |
| 1801358718 | Travis J Ray | Physical Therapy Assistant | 501 E Front Ave, Stockton, IL 61085-1444 | 2019-04-01 |
| 1104110816 | Stockton Healthcare and Rehab Center Inc | Skilled Nursing Facility | 501 E Front Ave, Stockton, IL 61085-1444 | 2011-05-31 |
| 1770662314 | Wright Nursing Home, Inc | Nursing Facility/Intermediate Care Facility | 501 E Front Ave, Stockton, IL 61085-1421 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316330152 | Waverly Place of Stockton, LLC | Skilled Nursing Facility | 501 E Front Avenue, Stockton, IL 61085 | 2015-03-17 |
| 1033603790 | Caitlin M Pullara | Dentist | 120 W Front Ave, Stockton, IL 61085 | 2018-06-17 |
| 1598935504 | Carroll & Jo Davies & Stephenson Roe | Case Manager/Care Coordinator | 500 N Rush St, Stockton, IL 61085-1004 | 2008-03-05 |
| 1215105291 | Stockton Cusd 206 | Local Education Agency (LEA) | 500 N Rush St # M, Suite A, Stockton, IL 61085-1004 | 2008-02-13 |
| 1356587364 | Tracy L. Boyer | Occupational Therapist | 517 W Hilltop Ter, Stockton, IL 61085-1025 | 2008-12-22 |
| 1700059805 | Kreider Services, Inc | Intermediate Care Facility, Mentally Retarded | 605 N Main St, Stockton, IL 61085-1121 | 2008-04-09 |
| 1629257332 | Joseph Stephan Cahill | Chiropractor | 307 N Hudson St, Stockton, IL 61085-1219 | 2007-10-30 |
| 1710052246 | Stephen F Petras | Dentist | 120 W Front Ave, Stockton, IL 61085-1318 | 2006-11-21 |
| 1093880536 | Stockton Dental Center, Inc. | Dentist | 120 W Front Ave, Stockton, IL 61085-1318 | 2006-11-21 |
| 1255955449 | Andrew John Gibbs | Pharmacist | 117 N Main St, Stockton, IL 61085-1321 | 2020-06-03 |
| Find all providers in zip 61085 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316330152 | Waverly Place of Stockton, LLC | Skilled Nursing Facility | 501 E Front Avenue, Stockton, IL 61085 | 2015-03-17 |
| 1932507431 | Sandra Rae Divine | Skilled Nursing Facility | 1015 Lancaster Dr, Stockton, MO 65785-8360 | 2014-12-15 |
| 1114323136 | Good Samaritan Care Provider LLC | Skilled Nursing Facility | 10740 Oakwilde Ave, Stockton, CA 95212-9249 | 2014-11-19 |
| 1801938816 | Covenant Care California, LLC | Skilled Nursing Facility | 9289 Branstetter Place, Stockton, CA 95209-1700 | 2007-02-13 |
| 1730269184 | O'connor Woods Housing Corp | Skilled Nursing Facility | 3110 Wagner Heights Rd, Stockton, CA 95209-4848 | 2006-10-17 |
| 1891700464 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 1517 E Knickerbocker Dr, Stockton, CA 95210-3119 | 2006-07-30 |
| 1548283542 | Stockton Edison Healthcare Corporation | Skilled Nursing Facility | 1630 N. Edison St., Stockton, CA 95204 | 2006-07-25 |
| 1871512046 | Helios Healthcare, LLC | Skilled Nursing Facility | 442 E Hampton St, Stockton, CA 95204-5519 | 2006-07-19 |
| 1922027002 | Helios Healthcare, LLC | Skilled Nursing Facility | 6940 Pacific Ave, Stockton, CA 95207-2602 | 2006-07-19 |
| 1487601704 | Sunbridge Stockton Rehabilitation Center LLC | Skilled Nursing Facility | 9107 Davis Rd, Stockton, CA 95209-1807 | 2006-05-30 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.