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HERITAGE WOODS OF ROCKFORD
NPI 1417142225
Assisted Living Facility in Rockford, IL

Active since September 14, 2007CLIA 14D2196851 · Waiver
202 N SHOW PLACE DR, ROCKFORD, IL 61107(815) 332-5777 Get Directions Write a Review

NPPES record last updated: September 14, 2007. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Heritage Woods Of Rockford NPPES

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

HERITAGE WOODS OF ROCKFORD (NPI 1417142225) is a healthcare organization registered as an assisted living facility in Rockford, Illinois and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through October 19, 2028 and lists Robert Mellon, Administrator, as its authorized official.

NPPES Registry Identity

NPI1417142225
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameHERITAGE WOODS OF ROCKFORD
Location Address202 N SHOW PLACE DRRockford, IL 61107
Mailing Address202 N Show Place DrRockford, IL 61107 · (815) 332-5777
Phone(815) 332-5777
Organization SubpartNo
Authorized OfficialRobert MellonAdministrator · (815) 332-5777
Enumeration DateSeptember 14, 2007
✔ NPI 1417142225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
202 N SHOW PLACE DR, Rockford, IL 61107
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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 14D2196851

Heritage Woods Of Rockford · Rockford, IL
Active · expires Oct 19, 2028
CLIA Number14D2196851
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 20, 2026
Certificate Expiration DateOctober 19, 2028
Laboratory DirectorJaclyn O Keefe
Laboratory Phone(815) 332-3700
Laboratory LocationHeritage Woods Of Rockford202 N Showplace Dr, Rockford, IL 61107
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

CHRISTOPHER ROSE MPT
Physical Therapist
202 N SHOW PLACE DR
ROCKFORD, IL 61107
Winnebago County (815) 847-9340
DEBRA JOHNSON BURNS M.A.,CCC-SLP
Speech-Language Pathologist
202 N SHOW PLACE DR
ROCKFORD, IL 61107
Winnebago County (815) 332-3700
BROGAN CANCIAMILLE
Occupational Therapist
202 N SHOW PLACE DR
ROCKFORD, IL 61107
Winnebago County (815) 332-3700

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 Woods Of Rockford's NPI number?

The NPI number for Heritage Woods Of Rockford is 1417142225. It was assigned to this organization in the NPPES registry on September 14, 2007.

Where is Heritage Woods Of Rockford located?

Heritage Woods Of Rockford is located at 202 N Show Place Dr, Rockford, IL 61107. The listed phone number is (815) 332-5777.

What is Heritage Woods Of Rockford's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Heritage Woods Of Rockford hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2196851) is associated with this NPI, valid through October 19, 2028. 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 Woods Of Rockford was last updated on September 14, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.