COUNTY OF FULTON (NPI# 1497889554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497889554 |
| Entity Type | Organization |
| Organization Name | COUNTY OF FULTON |
| Other Organization Name | THE CLAYBERG FULTON COUNTY NURSING CENTER |
| Practice Address |
625 East Monroe Street Cuba IL 61427-0200 |
| Mailing Address |
Po Box 200 625 East Monroe Street Cuba IL 61427-0200 |
| Practice Telephone | 3097855012 |
| Practice Fax Number | 3097855376 |
| Mailing Telephone | 3097855012 |
| Mailing Fax Number | 3097855376 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2012-11-02 |
| Authorized Official Name | MRS. MARTHA J DANIELSON (ADMINISTRATOR) |
| Authorized Official Telephone | 3097855012 |
| Authorized Official Credential | LNHA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | 0014290 | IL | Nursing & Custodial Care Facilities |
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 0014290 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 370914241001 | 05 |
| Other Name | Type Code |
|---|---|
| The Clayberg Fulton County Nursing Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073507307 | County of Fulton | Skilled Nursing Facility | 847 County Highway 122, Gloversville, NY 12078-6413 | 2005-09-01 |
| 1528379906 | County of Fulton | Public Health or Welfare | 100 N Main St, Lewistown, IL 61542-0111 | 2010-06-30 |
| 1801880083 | County of Fulton | Home Health | 847 County Highway 122, Gloversville, NY 12078-6413 | 2005-09-02 |
| Street Address |
625 EAST MONROE STREET |
| City | CUBA |
| State | IL |
| Zip Code | 61427-0200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992094551 | Jennifer June Lang | Speech-Language Pathologist | 625 E. Monroe St, Cuba, IL 61427 | 2011-04-05 |
| 1336371269 | Terrah L Cornell | Nurse Practitioner | 114 S 4th St, Cuba, IL 61427 | 2009-08-11 |
| 1750584918 | Fulton County Comm Dist 3 | Local Education Agency (LEA) | 669 E Main St, Cuba, IL 61427-5026 | 2007-06-06 |
| 1437609856 | Jessa Marie Tompkins | Specialist/Technologist | 122 S 1st St, Cuba, IL 61427-5047 | 2016-10-10 |
| 1942811369 | The Tlc Health and Wellness Clinic | Clinic/Center | 114 S 4th St, Cuba, IL 61427-5062 | 2020-08-10 |
| 1154518454 | Graham Hospital Association | Family Medicine | 114 S 4th St, Cuba, IL 61427-5062 | 2007-10-01 |
| 1275832404 | Becki Rachelle Wissel | Occupational Therapist | 625 E Monroe St, Cuba, IL 61427-5109 | 2011-03-28 |
| 1053923235 | Megan Kathleen Holliger | Physical Therapy Assistant | 625 E Monroe St, Cuba, IL 61427-5109 | 2020-08-19 |
| 1861785206 | Jennifer Lee Wagoner | Physical Therapist | 625 E Monroe St, Cuba, IL 61427-5109 | 2011-05-18 |
| 1598280133 | Stacie N Petitgout | Psychologist | 652 E Main St, Cuba, IL 61427-5211 | 2017-08-04 |
| Find all providers in zip 61427 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386094068 | Icg Home Health | Nursing Facility/Intermediate Care Facility | 4508 Camden Ct, Richton Park, IL 60471-1147 | 2016-06-14 |
| 1871999078 | Midwest Health Operations LLC | Nursing Facility/Intermediate Care Facility | 3601 16th Ave, Sterling, IL 61081-4059 | 2014-11-15 |
| 1437410891 | Mado Healthcare | Nursing Facility/Intermediate Care Facility | 1541 North Wells, Chicago, IL 60610-1307 | 2012-06-01 |
| 1134405392 | Faith Community Health Services, Inc | Nursing Facility/Intermediate Care Facility | 4449 177th St, Country Club Hills, IL 60478-4705 | 2011-11-01 |
| 1215188487 | Petersen Health Care, Inc | Nursing Facility/Intermediate Care Facility | 144 Jounior Ave., Kewanee, IL 61443 | 2008-10-07 |
| 1699936054 | Pinckneyville Healthcare Center | Nursing Facility/Intermediate Care Facility | 708 Virginia Ct, Pinckneyville, IL 62274-1538 | 2008-06-18 |
| 1184894412 | Parents and Friends of The Slc-home 1 | Nursing Facility/Intermediate Care Facility | 3 Gundlach Pl, Swansea, IL 62226-4227 | 2008-03-03 |
| 1740463074 | St. Joseph's Home of Springfield | Nursing Facility/Intermediate Care Facility | 3306 S 6th Street Rd, Springfield, IL 62703-4735 | 2007-12-10 |
| 1821283573 | Royal Living Center Inc | Nursing Facility/Intermediate Care Facility | 200 South 9th Street, New Baden, IL 62265 | 2007-09-06 |
| 1235323841 | Parents and Friends of Slc | Nursing Facility/Intermediate Care Facility | 1450 Caseyville Ave, Swansea, IL 62226-4517 | 2007-08-28 |
| Find all providers with the same taxonomy | ||||
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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.