FOUR FOUNTAINS CONVALESCENT CENTER
NPI 1366436453
Nursing Home Administrator in Belleville, IL
NPI Status: Active since September 06, 2005
Contact Information
101 S BELT W
BELLEVILLE, IL
ZIP 62220
Phone: (618) 277-7700
Fax: (618) 355-4050
- Organization
- Nursing Home Administrator
- Accepts Insurance
- CLIA Number: 14D0434004
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 08-31-2026
About FOUR FOUNTAINS CONVALESCENT CENTER
This page provides the complete NPI Profile along with additional information for Four Fountains Convalescent Center, a provider established in Belleville, Illinois operating as a Nursing Home Administrator. The healthcare provider is registered in the NPI registry with number 1366436453 assigned on September 2005. The practitioner's primary taxonomy code is 376G00000X with license number 0030304 (IL). The provider is registered as an organization and their NPI record was last updated 17 years ago. Four Fountains Convalescent Center operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mrs. Hope A Mcnitt R.n. L.n.h.a. (Licensed Nursing Home Administrator)
- NPI
- 1366436453
- Provider Name
- FOUR FOUNTAINS CONVALESCENT CENTER
- Entity Type
- Organization
- Location Address
- 101 S BELT W BELLEVILLE, IL 62220
- Location Phone
- (618) 277-7700
- Location Fax
- (618) 355-4050
- Mailing Address
- 101 S BELT W BELLEVILLE, IL 62220
- Mailing Phone
- (618) 277-7700
- Mailing Fax
- (618) 355-4050
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-06-2005
- Last Update Date
- 03-24-2009
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nursing Home Administrator
- Taxonomy Code
- 376G00000X
- Type
- Nursing Service Related Providers
- License No.
- 0030304
- License State
- IL
- Taxonomy Description
- An individual, often licensed by the state, who is responsible for the management of a nursing home.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Bronze Essential (No Referrals) - EPO
- UHC Bronze Standard (No Referrals) - EPO
- UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
- UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) - EPO
- UHC Gold Standard (No Referrals) - EPO
- UHC Silver Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
- UHC Silver Standard (No Referrals) - EPO
- UHC Silver Standard+ (Dental + Vision, No Referrals) - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| ========= | OTHER (01) | IL | UHC-MEDICARE COMPLETE |
| ========= | MEDICARE UPIN (02) | IL | |
| =========001 | MEDICAID (05) | IL | |
| 145241 | MEDICARE ID-TYPE UNSPECIFIED (04) | IL |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0434004
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- MICHELLE VANDORN M D
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Four Fountains Convalescent Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366436453, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366436453, enumerated as an "organization" on September 06, 2005.
The provider is located at 101 S BELT W BELLEVILLE, IL 62220 and the phone number is (618) 277-7700.
Nursing Home Administrator with taxonomy code 376G00000X.
The provider might be accepting Accepts: UnitedHealthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
