BOONE COUNTY COUNCIL ON AGING — NPI 1407283906 (Licensed & Credentialed In Home Supportive Care in BELVIDERE, IL)

CMS-1500 Box 24J / 33a • NPI

1407283906

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

253Z00000X

Licensed & Credentialed In Home Supportive Care

Box 32 Service Location & ZIP+4

2141 HENRY LUCKOW LN, BELVIDERE, IL, 61008-1700

✓ 9-Digit EDI 837 ZIP+4 (61008-1700)

Practice Phone & Referral Fax

(815) 544-9893

Fax: (815) 547-7373

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1407283906 (BOONE COUNTY COUNCIL ON AGING) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1407283906` (NPI-2 Organization / Facility)
Provider / Legal Name	BOONE COUNTY COUNCIL ON AGING
Plain-English Specialty	Licensed & Credentialed In Home Supportive Care NUCC Code: `253Z00000X` (In Home Supportive Care)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	2141 HENRY LUCKOW LN, BELVIDERE, IL, 61008-1700
Practice Telephone / Fax	Tel: (815) 544-9893 \| Fax: (815) 547-7373
Administrative Mailing Address	2141 HENRY LUCKOW LN, BELVIDERE, IL, 61008-1700
Enumeration & Last Sync	Enumerated: 2013-09-30 \| CMS Record Updated: 2013-09-30
Authorized Official	JOE FORTMANN (Executive Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2141 HENRY LUCKOW LN, BELVIDERE, IL, 61008-1700

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Plain-English Taxonomy & CMS Crosswalk (253Z00000X)

What Does Taxonomy Code 253Z00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 253Z00000X translates to:
"Licensed & Credentialed In Home Supportive Care"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified In Home Supportive Care for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BOONE COUNTY COUNCIL ON AGING)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`253Z00000X` — In Home Supportive Care Plain English: Licensed & Credentialed In Home Supportive Care	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BOONE COUNTY COUNCIL ON AGING (NPI #1407283906)