ST PAULS SENIOR COMMUNITY LLC (NPI# 1710973284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710973284 |
| Entity Type | Organization |
| Organization Name | ST PAULS SENIOR COMMUNITY LLC |
| Other Organization Name | ST. PAUL'S HOME |
| Practice Address |
1021 W E St Belleville IL 62220-1055 |
| Practice Telephone | 6182332095 |
| Practice Fax Number | 6182332109 |
| Mailing Telephone | 6182332095 |
| Mailing Fax Number | 6182332109 |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-05-14 |
| Authorized Official Name | ELIZABETH ANN PAPIN (MEDICARE BILLING SPECIALIST) |
| Authorized Official Telephone | 6362220060 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 0013920 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| ST. PAUL'S HOME | Doing Business As Name - Organization |
| Street Address |
1021 W E ST |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62220-1055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962076 | Tevin Burks | Physical Therapist | 1021 W E St, Belleville, IL 62220-1055 | 2020-11-02 |
| 1093314429 | Che' Nicole Lang | Physical Therapy Assistant | 1021 W E St, Belleville, IL 62220-1055 | 2020-10-16 |
| 1336705508 | Taylor Lynne Stratton | Speech-Language Pathologist | 1021 W E St, Belleville, IL 62220-1055 | 2019-05-14 |
| 1891359733 | Alexis Joelle Marshall | Occupational Therapy Assistant | 1021 W E St, Belleville, IL 62220-1055 | 2019-04-25 |
| 1083182596 | Doris A Thole | Physical Therapist | 1021 W E St, Belleville, IL 62220-1055 | 2018-11-02 |
| 1912453358 | Cep America - Illinois Snf, LLP | Nursing Facility/Intermediate Care Facility | 1021 W E St, Belleville, IL 62220-1055 | 2016-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1437675535 | Prorehab PC | Occupational Therapist | 1915 Carlyle Ave, Ste D, Belleville, IL 62220 | 2017-08-21 |
| 1629527650 | Arika Forrest | Nurse Practitioner | 140 Iowa Ave, Belleville, IL 62220 | 2016-10-03 |
| 1861861403 | Belleville Endoscopy LLC | Internal Medicine | 311 West Lincoln St, Suite 101, Belleville, IL 62220 | 2015-09-24 |
| 1962871558 | Antony Frierdich | Specialist/Technologist | 22 South 13th Street, Belleville, IL 62220 | 2015-09-24 |
| 1588032858 | Dana Wright | Pharmacist | 211 South Thrid Street, Belleville, IL 62220 | 2015-09-03 |
| 1629208731 | Lisa Marlow Johnson | Developmental Therapist | 34 Fenwood Dr, Belleville, IL 62220 | 2009-07-23 |
| 1841361623 | Neurological Surgery of Belleville | Neurological Surgery | 340 West Lincoln Street, Suite 540, Belleville, IL 62220 | 2006-11-13 |
| 1689769119 | Kathy Jo Corn | Counselor | 521 W. Main, Suite 201 B, Belleville, IL 62220 | 2006-10-03 |
| 1780609578 | Southern Illinois Health Care Foundation, Inc. | Counselor | 180 S 3rd St Ste 103&104, Belleville, IL 62220 | 2006-07-13 |
| Find all providers in zip 62220 | ||||
| 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 |
|---|---|---|---|---|
| 1912453358 | Cep America - Illinois Snf, LLP | Nursing Facility/Intermediate Care Facility | 1021 W E St, Belleville, IL 62220-1055 | 2016-08-26 |
| 1881608669 | Great Plains of Republic County, Inc. | Nursing Facility/Intermediate Care Facility | 2420 G St, Belleville, KS 66935-2400 | 2006-07-28 |
| 1356348221 | Willowcreek Rehab and Nursing Center | Nursing Facility/Intermediate Care Facility | 40 N 64th St, Belleville, IL 62223-3808 | 2005-07-06 |
| 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 | ||||
| City | BELLEVILLE |
| Zip Code | 62220 |
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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.