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HERITAGE HEALTH
NPI 1093059701
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies in Carlinville, IL

Active since November 19, 2012CLIA 14D0044623 · Waiver
1200 UNIVERSITY ST, CARLINVILLE, IL 62626(217) 854-4433(217) 854-6291 Get Directions Write a Review

NPPES record last updated: October 18, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Heritage Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HERITAGE HEALTH (NPI 1093059701) is a healthcare organization registered as an oxygen equipment & supplies in Carlinville, Illinois and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists David Underwood, Exec Vp, Cfo, as its authorized official.

NPPES Registry Identity

NPI1093059701
Entity TypeOrganization
Primary Taxonomy332BX2000X
Legal Business NameHERITAGE MANOR - CARLINVILLE, LLC
Location Address1200 UNIVERSITY STCarlinville, IL 62626-9600
Mailing Address115 W Jefferson St, Suite 401Bloomington, IL 61701-3946 · (309) 828-4361 · Fax (309) 829-5477
Phone(217) 854-4433
Fax(217) 854-6291
Organization SubpartYesParent: Heritage Enterprises, Inc
Authorized OfficialDavid UnderwoodExec Vp, Cfo · (309) 823-7135
Enumeration DateNovember 19, 2012
Last NPPES UpdateOctober 18, 2016
✔ NPI 1093059701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical Supplies · Oxygen Equipment & SuppliesSuppliers
Taxonomy Code332BX2000X
1200 UNIVERSITY ST, Carlinville, IL 62626
Open in Google Maps ↗

Other Names 1

Doing Business AsHeritage Health

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0044623

Heritage Manor Carlinville · Carlinville, IL
Active · expires Aug 31, 2026
CLIA Number14D0044623
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKarla Smith, R N, L N H A
Laboratory Phone(217) 854-4433
Laboratory LocationHeritage Manor Carlinville1200 University Avenue, Carlinville, IL 62626
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILL CHRISTINE MILLER COTA/L
Occupational Therapy Assistant
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433
JOAN BROWN
Physical Therapy Assistant
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 954-4433
MAKINZE DC COX
Occupational Therapy Assistant
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433
COURTNEY LYNN WATERS
Physical Therapy Assistant
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433
SARAH MYERS-ELLER COTA/L
Occupational Therapy Assistant
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433
CHEYENNE MACKENZIE HELLMANN
Physical Therapy Assistant
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433
LAKESIDE HEALTH AND REHAB CENTER LLC
Skilled Nursing Facility
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433
LAKESIDE HEALTH AND REHAB CENTER LLC
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1200 UNIVERSITY ST
CARLINVILLE, IL 62626
Macoupin County (217) 854-4433

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heritage Manor - Carlinville, LLC's NPI number?

The NPI number for Heritage Manor - Carlinville, LLC is 1093059701. It was assigned to this organization in the NPPES registry on November 19, 2012.

Where is Heritage Manor - Carlinville, LLC located?

Heritage Manor - Carlinville, LLC is located at 1200 University St, Carlinville, IL 62626. The listed phone number is (217) 854-4433.

What is Heritage Manor - Carlinville, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies, specializing in Oxygen Equipment & Supplies, with taxonomy code 332BX2000X.

Does Heritage Manor - Carlinville, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0044623) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Heritage Manor - Carlinville, LLC was last updated on October 18, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.