Organization Active NPI

Truman Valley Health Care, Inc.

Doing business as Windsor Healthcare & Rehab Center

  • Skilled Nursing Facility
  • Windsor, MO
National Provider Identifier
1063408276
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
031252 Issued in MO
Legal business name
TRUMAN VALLEY HEALTH CARE, INC.
Doing business as
Windsor Healthcare & Rehab Center
Practice address
809 W Benton St
Windsor, MO 65360-1239
Phone
(660) 647-3102
Fax
(660) 647-5972
NPI assigned
Sep 22, 2005
Last updated
Nov 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. James C Lincoln
Title
Shareholder
Phone
(573) 746-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 031252 MO Primary

Addresses

Primary practice location

809 W Benton St
Windsor, MO 65360-1239

Mailing address

809 W Benton St
Windsor, MO 65360-1239
Phone (660) 647-3102

Other identifiers 2

IdentifierTypeStateIssuer
15223159OtherMOSTATE ID
103102406MedicaidMO

Other names 1

  • Windsor Healthcare & Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111027000943 MO Part A Provider - Skilled Nursing Facility 3476726969 Practice locations: Windsor, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063408276. Details of each certification follow.

Skilled nursing facility certification: CCN 265683

Legal name
TRUMAN VALLEY HEALTH CARE, INC.
Doing business as
WINDSOR HEALTHCARE & REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 4, 1997
Last certification
Dec 14, 2023
Beds
60
Ownership / control type
Corporation
Multi-facility organization
TUTERA GROUP / WALNUT CREEK MANAGEMENT
Organization structure
CorporationProprietary
Incorporated
Mar 1, 2003 in MO
Enrollment address
809 W Benton St
Windsor, MO 65360-1239
Nursing home name
WINDSOR REHABILITATION & HEALTH CARE CENTER
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Windsor Rehabilitation & Health Care CenterCCN 265683 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 4, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6030.6 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0893050Windsor Healthcare and Rehab809 West Benton, Windsor, MO 65360Certificate of waiverOct 12, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Brandon Bysor Individual Corporate DirectorMember Mar 15, 2023 50%
Charlotte a Stutts Individual Corporate OfficerSecretary Mar 1, 2003 50%
Truman Valley Health Care, Inc. Organization, Windsor, MO Corporation Operational/Managerial Control Mar 1, 2003 100%
Timothy O Drake Individual Corporate OfficerPresident Mar 15, 2023 50%
Clara E Merrill Individual W-2 Managing EmployeeAdministrator Aug 17, 2015 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Mar 1, 2003 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Mar 1, 2003 50%

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1063408276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 W BENTON ST",
            "city": "WINDSOR",
            "state": "MO",
            "postal_code": "653601239",
            "telephone_number": "660-647-3102",
            "fax_number": "660-647-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 W BENTON ST",
            "city": "WINDSOR",
            "state": "MO",
            "postal_code": "653601239",
            "telephone_number": "660-647-3102",
            "fax_number": "660-647-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUMAN VALLEY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "LINCOLN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "573-746-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "15223159",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103102406",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windsor Healthcare & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Windsor, MO

Sources for this page

Verify at the official NPI Registry.