Active NPI
Truman Valley Health Care, Inc.
Doing business as Windsor Healthcare & Rehab Center
- Skilled Nursing Facility
- Windsor, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 031252
- 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, 2011
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15223159 | Other | MO | STATE ID |
| 103102406 | Medicaid | MO |
Other names 1
- Windsor Healthcare & Rehab Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- 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 Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 4, 1997
- Medicare certification status
- Active
- Certified beds
- 60
- Chain
- James & Judy Lincoln
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0893050 | Windsor Healthcare and Rehab | Certificate of waiver | Oct 12, 2026 |
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Brandon Bysor | Corporate Director | Mar 15, 2023 | 50% |
| Charlotte a Stutts | Corporate Officer | Mar 1, 2003 | 50% |
| Truman Valley Health Care, Inc. | Operational/Managerial Control | Mar 1, 2003 | 100% |
| Timothy O Drake | Corporate Officer | Mar 15, 2023 | 50% |
| Clara E Merrill | W-2 Managing Employee | Aug 17, 2015 | 100% |
| James C Lincoln | 5% Or Greater Direct Ownership Interest | Mar 1, 2003 | 50% |
| Judy L Lincoln | 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.
-
- Family Medicine Physician
- Branson, MO
- NPI 1568959674
-
- Family Medicine Physician
- Clinton, MO
- NPI 1528036324
-
- Family Medicine Physician
- Independence, MO
- NPI 1306817986
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.