CMS-1500 Box 24J / 33a • NPI
1750372801
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
314000000X (CMS A1[8])
Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)
Box 32 Service Location & ZIP+4
201 LOCUST ST, MINONK, IL, 61760-1511
✓ 9-Digit EDI 837 ZIP+4 (61760-1511)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1750372801 (HERITAGE MANOR MINONK, LLC) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1750372801 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | HERITAGE MANOR MINONK, LLC |
| Plain-English Specialty | Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF) NUCC Code: 314000000X (Skilled Nursing Facility) |
| Certifying / Licensing Body | CMS Five-Star Quality Rating System / State Department of Health |
| Practice Location Address | 201 LOCUST ST, MINONK, IL, 61760-1511 |
| Practice Telephone / Fax | Tel: (309) 432-2557 | Fax: (309) 432-3330 |
| Administrative Mailing Address | 115 W JEFFERSON ST, BLOOMINGTON, IL, 61701-3946 |
| Enumeration & Last Sync | Enumerated: 2005-10-28 | CMS Record Updated: 2014-06-12 |
| Authorized Official | DAVID UNDERWOOD (Sr. V.P. & CFO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (314000000X)
What Does Taxonomy Code 314000000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 314000000X translates to:
"Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (HERITAGE MANOR MINONK, LLC)
Typical CPT / Diagnostic Procedures:- 24-Hour Skilled Nursing Supervision, Enteral Nutrition & Pressure Ulcer Prevention
- Post-Acute Orthopedic, Cardiac & Neurological Inpatient Rehabilitation
- Chronic Disease Maintenance Regimens, Analgesics & Thromboprophylaxis
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225XP0019X — Occupational Therapist, Physical RehabilitationPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: IL | License: Verified | Primary: Secondary |
224Z00000X — Occupational Therapy AssistantPlain English: Licensed & Credentialed Occupational Therapy Assistant | State: IL | License: Verified | Primary: Secondary |
2251G0304X — Physical Therapist, GeriatricsPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist, Geriatrics | State: IL | License: Verified | Primary: Secondary |
225200000X — Physical Therapy AssistantPlain English: Licensed & Credentialed Physical Therapy Assistant | State: IL | License: Verified | Primary: Secondary |
235Z00000X — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers | State: IL | License: Verified | Primary: Secondary |
314000000X — Skilled Nursing FacilityPlain English: Licensed Skilled Nursing & Inpatient Post-Acute Rehabilitation Facility (SNF) | State: IL | License: 48058 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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