CARONDELET LONG TERM CARE FACILITIES, INC. (NPI# 1710979836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710979836 |
| Entity Type | Organization |
| Organization Name | CARONDELET LONG TERM CARE FACILITIES, INC. |
| Other Organization Name | ST. MARY'S MANOR |
| Practice Address |
111 Nw Mock Ave Blue Springs MO 64014-2503 |
| Practice Telephone | 8162285655 |
| Practice Fax Number | 8162288480 |
| Mailing Telephone | 8162285655 |
| Mailing Fax Number | 8162288480 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2014-10-27 |
| Authorized Official Name | MR. ANTHONY COLUMBATTO (ADMINISTRATOR, CEO) |
| Authorized Official Telephone | 8162285655 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 031289 | MO | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 102390309 | 05 |
| Other Name | Type Code |
|---|---|
| St. Mary's Manor | Doing Business As Name - Organization |
| Street Address |
111 NW MOCK AVE |
| City | BLUE SPRINGS |
| State | MO |
| Zip Code | 64014-2503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982232815 | Ignite Medical Resort St. Marys, LLC | Skilled Nursing Facility | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2020-03-27 |
| 1003372574 | Shelby Liles | Occupational Therapy Assistant | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2019-02-20 |
| 1003050337 | Valaree Rosann Smith | Family Medicine | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2009-04-30 |
| 1538361316 | Donna Joann Yager | Physical Therapy Assistant | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-06-04 |
| 1548470818 | Sandra F Engbroten | Occupational Therapy Assistant | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-23 |
| 1417167594 | Allyson Renee Speer Gerber | Occupational Therapist | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-23 |
| 1740490788 | Emma Mullen | Physical Therapy Assistant | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-22 |
| 1972712099 | Mary A. Fletcher | Occupational Therapy Assistant | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-22 |
| 1922217975 | Lisa M Hill | Occupational Therapist | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-22 |
| 1710197660 | Dee Anna Mccune | Physical Therapist | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2007-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756319 | Ltaj Properties LLC | Physical Therapist | 514 Nw State 7 Hwy, Suite A, Blue Springs, MO 64014 | 2020-10-05 |
| 1790397198 | Miranda Bramble | Pharmacist | 1701 Nw Highway 7, Blue Springs, MO 64014 | 2020-08-18 |
| 1659915098 | Cheif Smiles LLC | Dentist | 620 E. Us Highway 40, Blue Springs, MO 64014 | 2019-10-29 |
| 1629637764 | Beau Devereux Butzirus | Dentist | 1125 South Mo-7, Blue Springs, MO 64014 | 2019-06-12 |
| 1245725605 | Brian Geraghty | Orthopaedic Surgery | 201 Nw R D Mize Road, Blue Springs, MO 64014 | 2018-06-28 |
| 1588101224 | Andy Anderson | Prevention Professional | 2705 Nw 3rd Ter, Blue Springs, MO 64014 | 2017-01-19 |
| 1801250469 | Louis Spear | Dentist | 1215 A Nw 7 Highway, Blue Springs, MO 64014 | 2016-04-11 |
| 1083027411 | Alex Sharifian Dds Blue Springs Dentistry PC | Dentist | 1205 Ne Coronado Drive, Blue Springs, MO 64014 | 2014-06-03 |
| 1730512336 | Valerie Fombon | Pharmacist | 625 W 40 Hwy, Blue Springs, MO 64014 | 2013-08-19 |
| 1356692750 | Central Jackson County Fire Protection District | Ambulance | 805 Ne Jefferson St, Blue Springs, MO 64014 | 2012-09-25 |
| Find all providers in zip 64014 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609492719 | Ignite Medical Resort Independence LLC | Skilled Nursing Facility | 20511 E. Trinity Pl., Blue Springs, MO 64015 | 2020-06-24 |
| 1851429989 | Blue Springs Care Center | Skilled Nursing Facility | 930 Ne Duncan Rd, Blue Springs, MO 64014 | 2007-03-01 |
| 1982232815 | Ignite Medical Resort St. Marys, LLC | Skilled Nursing Facility | 111 Nw Mock Ave, Blue Springs, MO 64014-2503 | 2020-03-27 |
| 1578196747 | Shangri La Hco, LLC | Skilled Nursing Facility | 930 Ne Duncan Rd, Blue Springs, MO 64014-2173 | 2020-02-17 |
| 1215163852 | Shangri La Hco, LLC | Skilled Nursing Facility | 930 Ne Duncan Rd, Blue Springs, MO 64014-2173 | 2009-06-10 |
| 1447436274 | Phsl, LLC | Skilled Nursing Facility | 930 Ne Duncan Rd, Blue Springs, MO 64014-2173 | 2008-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760006308 | Sunterra Dardenne Prairie Oc LLC | Skilled Nursing Facility | 7275 Highway N, Dardenne Prairie, MO 63368-7126 | 2020-05-29 |
| 1184247215 | Berry Medical Properties, LLC | Skilled Nursing Facility | 11380 Natural Bridge Rd, Bridgeton, MO 63044-2307 | 2020-05-23 |
| 1881249464 | Rolla Grand LLC | Skilled Nursing Facility | 1800 White Columns Dr, Rolla, MO 65401-2044 | 2019-08-09 |
| 1184276982 | Willow Health Care Inc | Skilled Nursing Facility | 712 Copper Rock Dr, Rogersville, MO 65742-8970 | 2019-07-11 |
| 1548734627 | Medicore Medical Service LLC | Skilled Nursing Facility | 2303 Kratky Rd Apt B, Saint Louis, MO 63114-1783 | 2019-01-11 |
| 1518436724 | Missouri Nursing & Rehab LLC | Skilled Nursing Facility | 783 Weber Road, Farmington, MO 63640-3318 | 2018-11-16 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1578039467 | Laverna Senior Living LLC | Skilled Nursing Facility | 904 S Hall Ave, Savannah, MO 64485-1952 | 2018-10-17 |
| 1093297152 | Community Care Center of Union Inc | Skilled Nursing Facility | 1080 Marie Lane, Union, MO 63084 | 2018-09-05 |
| 1487132890 | Winchester Nursing Center Inc | Skilled Nursing Facility | 400 Winchester Road, Bernie, MO 63822-0760 | 2018-07-30 |
| Find all providers with the same taxonomy | ||||
| City | BLUE SPRINGS |
| Zip Code | 64014 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.