ELDERCARE, INC. (NPI# 1902051154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902051154 |
| Entity Type | Organization |
| Organization Name | ELDERCARE, INC. |
| Other Organization Name | CALVIN JOHNSON CARE CENTER |
| Practice Address |
727 North 17th Street Belleville IL 62226-6599 |
| Mailing Address |
2810 Frank Scott Parkway West Suite 820 Bellesville IL 62223-5007 |
| Practice Telephone | 6182343323 |
| Practice Fax Number | 6182349477 |
| Mailing Telephone | 6182342273 |
| Mailing Fax Number | 6182347777 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MR. STEVEN C. WOLF (PRESIDENT) |
| Authorized Official Telephone | 6182342273 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | 1400434197 | IL | Laboratories |
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 314000000X | Skilled Nursing Facility | 0023309 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA (VETERANS' ADMIN) | V255P(657)0911 | 01 | |
| MO | 103025508 | 05 |
| Other Name | Type Code |
|---|---|
| Calvin Johnson Care Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | ELDERCARE, INC. | 87 Jersey St., Marblehead, MA 01945 |
| Colorado Business Entities | Eldercare, Inc. | 183 S Hwy 67, Sedalia, CO 80135 |
| Street Address |
727 NORTH 17TH STREET |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-6599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| 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 |
|---|---|---|---|---|
| 1982686093 | Eldercare Inc | Skilled Nursing Facility | 727 N 17th St, Belleville, IL 62226-6552 | 2005-11-15 |
| 1952398414 | Belleville Healthcare & Rehab Center | Skilled Nursing Facility | 150 N 27th St, Belleville, IL 62226-6621 | 2005-09-30 |
| 1801899000 | Westview Manor Health Care Associates Inc | Skilled Nursing Facility | 2626 Wesleyan Dr, Belleville, KS 66935-2440 | 2005-05-23 |
| 1245538149 | Belleville Behavioral Health | Skilled Nursing Facility | 727 N 17th St, Belleville, IL 62226-6552 | 2011-03-02 |
| 1902125321 | Great Plains of Republic Co, Inc. | Skilled Nursing Facility | 2420 G St, Belleville, KS 66935-2400 | 2010-05-25 |
| 1861629156 | Clara Maass Medical Center | Skilled Nursing Facility | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2009-06-15 |
| 1982855052 | Helia Southbelt Healthcare, LLC | Skilled Nursing Facility | 101 S Belt W, Belleville, IL 62220-2503 | 2008-10-07 |
| 1124205901 | Hmg Park Manor of Belleville, LLC | Skilled Nursing Facility | 2626 Wesleyan Dr, Belleville, KS 66935-2440 | 2008-01-24 |
| 1760667208 | Helia Healthcare of Belleville LLC | Skilled Nursing Facility | 40 N 64th St, Belleville, IL 62223-3808 | 2008-01-03 |
| 1386766244 | Clara Maass Medical Center | Skilled Nursing Facility | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2007-04-04 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 62226 |
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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.