GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC (NPI# 1720059520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720059520 |
| Entity Type | Organization |
| Organization Name | GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC |
| Other Organization Name | GATEWAY REGIONAL MEDICAL CENTER |
| Practice Address |
2100 Madison Ave Granite City IL 62040-4701 |
| Mailing Address |
Po Box 503706 Saint Louis MO 63150-3706 |
| Practice Telephone | 6187983000 |
| Practice Fax Number | 6187983724 |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-04-26 |
| Authorized Official Name | TARA P RICHARDSON (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6152213672 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRANITE CITY ILLINOIS HOSPITAL COMPANY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1010199 | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Gateway Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417353087 | Granite City Illinois Hospital Company LLC | Clinic/Center | 4273 S State Route 159, Glen Carbon, IL 62034-3224 | 2014-11-10 |
| 1083685986 | Granite City Illinois Hospital Company LLC | Psychiatric Unit | 2100 Madison Ave, Granite City, IL 62040-4701 | 2006-01-30 |
| 1447221247 | Granite City Illinois Hospital Company LLC | Psychiatric Unit | 2100 Madison Ave, Granite City, IL 62040-4701 | 2006-01-30 |
| 1083685887 | Granite City Illinois Hospital Company LLC | Rehabilitation Unit | 2100 Madison Ave, Granite City, IL 62040-4701 | 2006-01-30 |
| Street Address |
2100 MADISON AVE |
| City | GRANITE CITY |
| State | IL |
| Zip Code | 62040-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439640 | Timothy Hipskind | Internal Medicine | 2100 Madison Ave, Granite City, IL 62040-4701 | 2005-06-30 |
| 1720606973 | Lisa Lawrence | Social Worker | 2100 Madison Ave, Granite City, IL 62040-4713 | 2020-07-13 |
| 1588283360 | Bridget Burwell | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2020-04-13 |
| 1457982050 | Steven T Hillmer | Dietitian, Registered | 2100 Madison Ave, Granite City, IL 62040-4713 | 2020-02-01 |
| 1366090573 | Donald Lee Clark IIi | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2019-08-30 |
| 1407412752 | Great River Radiology, Inc | Radiology | 2100 Madison Ave, Granite City, IL 62040 | 2019-05-13 |
| 1831601376 | Cep America - Illinois Snf, LLP | Internal Medicine | 2100 Madison Ave, Granite City, IL 62040-4713 | 2017-10-24 |
| 1467977561 | Anna Gilbreth | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2017-08-09 |
| 1952831893 | Kendall Brennan Knobeloch | Registered Nurse | 2100 Madison Ave, Granite City, IL 62040-4713 | 2017-06-13 |
| 1295262459 | Emily Marie Cottrell | Nurse Practitioner | 2100 Madison Ave, Granite City, IL 62040-4713 | 2017-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043736705 | Christine S Bieniecki Canada | Speech-Language Pathologist | 2300 West 25th St, Granite City, IL 62040 | 2017-08-15 |
| 1881085819 | James Watson | Counselor | 50 Northgate Industrial Drive, Granite City, IL 62040 | 2015-02-12 |
| 1518208719 | Chestnut Health Systems | Clinic/Center | 110 Northagte Industrial Drive, Granite City, IL 62040 | 2013-03-13 |
| 1952651697 | Victor Manuel Pinones | Dentist | 2130 Johnson Rd., Granite City, IL 62040 | 2012-09-10 |
| 1427360502 | Erin K Boerm | Occupational Therapist | 3540 Village Lane, Granite City, IL 62040 | 2010-07-06 |
| 1659503027 | Toni Lyn Siler | Counselor | 101 Whitsell Way, Apt 102, Pontoon Beach, IL 62040 | 2009-08-18 |
| 1871741462 | Fountain View Manor LLC | Alzheimer Center (Dementia Center) | 3432 Village Lane, Granite City, IL 62040 | 2008-09-08 |
| 1083880595 | Christina Marie Darin | Chiropractor | 2013 Johnson Road, Suite C & D, Granite City, IL 62040 | 2008-05-05 |
| 1629244322 | Julia Elaine Uhring Green | Counselor | 2429 Washinton Ave, Granite City, IL 62040 | 2008-05-02 |
| 1578786117 | John K Parker | Preventive Medicine | Veeder Health Center, 20th and Iowa, Granite City, IL 62040 | 2007-04-11 |
| Find all providers in zip 62040 | ||||
| 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 |
|---|---|---|---|---|
| 1760870224 | Amandas Mini Day Spa | Skilled Nursing Facility | 510 E Chain of Rocks Rd, Granite City, IL 62040-2803 | 2015-01-06 |
| 1356416465 | Granite Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 3500 Century Dr, Granite City, IL 62040-2166 | 2006-11-22 |
| 1558436600 | Stearns Nursing and Rehabilitation Center, LLC | Skilled Nursing Facility | 3900 Stearns Ave, Granite City, IL 62040-4154 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413537 | Citadel of Glenview LLC | Skilled Nursing Facility | 1700 E Lake Ave, Glenview, IL 60025-2003 | 2020-09-28 |
| 1598379075 | Patient Builders Marketing | Skilled Nursing Facility | 800 W Army Trail Rd, Carol Stream, IL 60188-9040 | 2020-09-02 |
| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1902428147 | Aperion Care Glenwood LLC | Skilled Nursing Facility | 19330 South College Grove, Glenwood, IL 60425 | 2020-05-11 |
| 1487273330 | Residential Alternatives of Illinois, Inc | Skilled Nursing Facility | 2203 Flagg Rd, Rochelle, IL 61068 | 2020-04-10 |
| 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 | GRANITE CITY |
| Zip Code | 62040 |
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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.