SSC ODIN OPERATING COMPANY LLC (NPI# 1477674174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477674174 |
| Entity Type | Organization |
| Organization Name | SSC ODIN OPERATING COMPANY LLC |
| Other Organization Name | ODIN HEALTHCARE CENTER |
| Practice Address |
300 Green St Odin IL 62870-1062 |
| Mailing Address |
5300 W Sam Houston Pkwy N Suite 100 Houston TX 77041-5161 |
| Practice Telephone | 6187756444 |
| Mailing Telephone | 8324676000 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2015-04-10 |
| Authorized Official Name | KELLE C SANTORO (SR DIRECTOR AR) |
| Authorized Official Telephone | 8324675728 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1725534 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Odin HealthCare Center | Doing Business As Name - Organization |
| Street Address |
300 GREEN ST |
| City | ODIN |
| State | IL |
| Zip Code | 62870-1062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669023313 | Cheryl T Merchant | Speech-Language Pathologist | 300 Green St, Odin, IL 62870-1062 | 2019-09-24 |
| 1790335479 | Christilyn Wacker | Physical Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-16 |
| 1285284000 | Brittany Leight Shuler | Physical Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-13 |
| 1700435757 | Kathy L Reynolds | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1265081277 | Tisha Jo Rueter | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1497304448 | Janie Sue Zimmerman | Occupational Therapy Assistant | 300 Green St, Odin, IL 62870-1062 | 2019-09-11 |
| 1588211395 | Kaylee Beth Heinzmann | Speech-Language Pathologist | 300 Green St, Odin, IL 62870-1062 | 2019-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235683855 | Kd Smith | Counselor | 904 East Martin Luther King, Dr, Centralia, IL 62870 | 2016-08-11 |
| 1093917569 | Odin Grade Sch 122 | Local Education Agency (LEA) | 100 Merritt, Odin, IL 62870-0250 | 2007-06-05 |
| 1902008477 | Odin Hs 700 | Local Education Agency (LEA) | 100 Merritt, Odin, IL 62870-0250 | 2007-06-05 |
| 1063792141 | Odin Public School District 722 | Local Education Agency (LEA) | 102 S Merritt St, Odin, IL 62870-1112 | 2011-08-22 |
| 1912020934 | Marion County Ambulance Service Inc. | Ambulance | 110 S. Wood St., 207, Odin, IL 62870-1185 | 2007-04-06 |
| 1912553892 | Kelly Ruth Hall | Nurse Practitioner | 1680 Community Beach Rd, Odin, IL 62870-2100 | 2019-08-15 |
| 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. |
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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.