CAPITOL CARE CENTER, LLC (NPI# 1104034289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104034289 |
| Entity Type | Organization |
| Organization Name | CAPITOL CARE CENTER, LLC |
| Practice Address |
555 W Carpenter St Springfield IL 62702-4905 |
| Mailing Address |
7444 Long Ave Skokie IL 60077-3214 |
| Practice Telephone | 8473294100 |
| Mailing Telephone | 8473294100 |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. BEN KLEIN (MANAGER) |
| Authorized Official Telephone | 8473294100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0045666 | IL | Nursing & Custodial Care Facilities |
| Street Address |
555 W CARPENTER ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-4905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215579107 | Aperion Care Capitol LLC | Durable Medical Equipment & Medical Supplies | 555 W Carpenter St, Springfield, IL 62702-4905 | 2019-10-11 |
| 1285144535 | Aperion Care Capitol LLC | Durable Medical Equipment & Medical Supplies | 555 W Carpenter St, Springfield, IL 62702-4905 | 2017-10-01 |
| 1518392562 | Debra Krick | Speech-Language Pathologist | 555 W Carpenter St, Springfield, IL 62702-4905 | 2013-09-10 |
| 1427499052 | Rehabcare | Skilled Nursing Facility | 555 W Carpenter St, Springfield, IL 62702-4905 | 2013-07-11 |
| 1154663045 | Wilson Kibungei Malit | Contractor | 555 W Carpenter St, Springfield, IL 62702-4905 | 2013-03-19 |
| 1801130539 | Capitol Healthcare and Rehabilitation Centre LLC | Skilled Nursing Facility | 555 W Carpenter St, Springfield, IL 62702-4905 | 2012-11-19 |
| 1609152057 | Jennifer Leigh Scales | Nurse Practitioner | 555 W Carpenter St, Springfield, IL 62702-4905 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| 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 |
|---|---|---|---|---|
| 1508373838 | Sunterra Springfield Oc, LLC | Skilled Nursing Facility | 4935 S National Ave, Springfield, MO 65810 | 2018-01-09 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1376054197 | Trilogy Healthcare Operations of Springfield II, LLC | Skilled Nursing Facility | 2900 Bechtle Avenue, Springfield, OH 45504 | 2017-10-19 |
| 1033559349 | Marquis Care | Skilled Nursing Facility | 25 U St, Springfield, OR 97477-2155 | 2013-07-01 |
| 1447592118 | Ojcc LLC | Skilled Nursing Facility | 3089 Old Jacksonville Rd, Springfield, IL 62704-6486 | 2013-03-20 |
| 1225310246 | Lutheran Retirement Center Association | Skilled Nursing Facility | 4101 W Iles Ave, Springfield, IL 62711-7051 | 2011-09-15 |
| 1073747077 | The Maples Health and Rehabilitation, LLC | Skilled Nursing Facility | 610 W Sunset St, Springfield, MO 65807-3696 | 2009-05-06 |
| 1396862314 | Good Shepherd Village LLC | Skilled Nursing Facility | 422 N Burnett Rd, Springfield, OH 45503-4821 | 2007-03-23 |
| 1346374949 | Woodland Manor Limited Partnership | Skilled Nursing Facility | 2000 Villa Rd, Springfield, OH 45503-1761 | 2007-03-15 |
| 1255465928 | N & R of Greene Haven LLC | Skilled Nursing Facility | 910 S West Ave, Springfield, MO 65802-9999 | 2007-03-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.