Jerseyville Nursing and Rehabilitation Center – Skilled Nursing Facility, NPI 1114915675
Skilled Nursing Facility
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Jerseyville Nursing and Rehabilitation Center
1140, Lake Street, Oak Park, Montgomery, Montgomery County, Alabama, 36104, United States
SUITE 410
OAK PARK, IL 603011049
Phone: (312) 994-2306
Fax: (312) 896-5951
Type: Mailing
500 NW PLAZA DR STE 712
SAINT ANN, MO 630742222
Phone: (314) 317-2003
Fax: (312) 896-5951
Type: Mailing
Jerseyville Nursing & Rehab Center, 1001, South State Street, Jerseyville, Jersey County, Illinois, 62052, United States
JERSEYVILLE, IL 620522361
Phone: (618) 498-6496
Fax: (618) 498-7435
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-05-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20150527002329 | O | Skilled Nursing Facility | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60301)
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