WHITE HALL NURSING AND REHABILITATION CENTER, LLC (NPI# 1023183431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023183431 |
| Entity Type | Organization |
| Organization Name | WHITE HALL NURSING AND REHABILITATION CENTER, LLC |
| Practice Address |
620 W Bridgeport St White Hall IL 62092-1001 |
| Mailing Address |
Po Box 428 Orchard Park NY 14127-0428 |
| Practice Telephone | 2173742144 |
| Practice Fax Number | 2173746714 |
| Mailing Telephone | 7166624955 |
| Mailing Fax Number | 7166679230 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2011-11-03 |
| Authorized Official Name | MR. NORBERT A BENNETT (CO-CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7166624955 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0046896 | IL | Nursing & Custodial Care Facilities |
| Street Address |
620 W BRIDGEPORT ST |
| City | WHITE HALL |
| State | IL |
| Zip Code | 62092-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043731540 | Vidit Atul Phanse | Physical Therapist | 620 W Bridgeport St, White Hall, IL 62092-1001 | 2017-07-05 |
| 1194113514 | Brenn Killion | Specialist | 620 W Bridgeport St, White Hall, IL 62092-1001 | 2015-01-07 |
| 1619386430 | Amy Lynn Heitzig | Physical Therapy Assistant | 620 W Bridgeport St, White Hall, IL 62092-1001 | 2014-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619302510 | Netherine Lann Valencia Agsalda | Physical Therapist | 620 W Bridgeport St., White Hall Nursing and Rehab, White Hall, IL 62092 | 2013-09-10 |
| 1023292265 | Pamida Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 116 N Main, White Hall, IL 62092 | 2007-12-24 |
| 1518024009 | Sherdel Janssen | Registered Nurse | 505 S Main St, White Hall, IL 62092-1002 | 2007-01-03 |
| 1366535304 | Thomas H. Boyd Memorial Hospital | Clinic/Center | 116a N Main St, White Hall, IL 62092-1054 | 2006-10-02 |
| 1003416546 | Jeremy Elliott | Nurse Practitioner | 116a N Main St, White Hall, IL 62092-1054 | 2020-10-26 |
| 1295078137 | Pharmacy Plus, Inc. | Pharmacy | 116 N Main St, White Hall, IL 62092-1054 | 2013-03-28 |
| 1760767743 | Jason Campbell | Pharmacist | 116 N Main St, White Hall, IL 62092-1054 | 2011-10-20 |
| 1588798045 | Janice Knight Breece | Pharmacist | 116 N Main St, White Hall, IL 62092-1054 | 2007-03-15 |
| 1306970769 | Gary Lawrence Breece | Pharmacist | 116 N Main St, White Hall, IL 62092-1054 | 2007-03-15 |
| 1447300926 | City Drug Inc. | Pharmacy | 116 N Main St, White Hall, IL 62092-1054 | 2007-01-10 |
| Find all providers in zip 62092 | ||||
| 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 |
|---|---|---|---|---|
| 1821087651 | White Hall Nursing and Rehabilitation Center LLC | Skilled Nursing Facility | 9209 Dollarway, White Hall, AR 71612 | 2005-10-14 |
| 1609350073 | The Waters of White Hall, LLC | Skilled Nursing Facility | 9209 Dollarway Rd, White Hall, AR 71602-2616 | 2018-09-20 |
| 1447624895 | White Hall Holdings LLC | Skilled Nursing Facility | 9209 Dollarway Rd, White Hall, AR 71602-2616 | 2015-11-23 |
| 1164837159 | White Hall Health & Rehab, LLC | Skilled Nursing Facility | 9209 Dollarway Rd, White Hall, AR 71602-2616 | 2014-06-27 |
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|---|---|---|---|---|
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| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
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| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 1114550381 | Rosiclare Hco, LLC | Skilled Nursing Facility | 55 Ferrell Rd, Rosiclare, IL 62982-1006 | 2020-02-17 |
| 1225672033 | All Ways Caring Services, Inc. | Skilled Nursing Facility | 301 N Neil St Ste 301, Champaign, IL 61820-3167 | 2019-11-05 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| Find all providers with the same taxonomy | ||||
| City | WHITE HALL |
| Zip Code | 62092 |
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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.