NPIMap

Organization Active NPI

C.M.C. Extended Care Center, Inc.

Doing business as Life Care Center of St. Louis

  • Skilled Nursing Facility
  • Saint Louis, MO
National Provider Identifier
1063469765
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
31339 Issued in MO
Legal business name
C.M.C. EXTENDED CARE CENTER, INC.
Doing business as
Life Care Center of St. Louis
Practice address
3520 Chouteau Ave
Saint Louis, MO 63103-2916
Phone
(314) 771-2100
Fax
(314) 771-7667
NPI assigned
May 28, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 31339 MO Primary

Addresses

Primary practice location

3520 Chouteau Ave
Saint Louis, MO 63103-2916

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other names 1

  • Life Care Center of St. Louis Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000550 MO Part A Provider - Skilled Nursing Facility 4082699269 Practice locations: Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063469765. Details of each certification follow.

Skilled nursing facility certification: CCN 265610

Legal name
C.M.C. EXTENDED CARE CENTER, INC.
Doing business as
LIFE CARE CENTER OF SAINT LOUIS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 6, 1995
Last certification
Apr 23, 2024
Beds
100
Ownership / control type
Individual
Multi-facility organization
CMC Extended Care Inc
Organization structure
CorporationProprietary
Incorporated
Mar 4, 1993 in MO
Enrollment address
3520 Chouteau Ave
Saint Louis, MO 63103-2916
Nursing home name
LIFE CARE CENTER OF ST LOUIS
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of St LouisCCN 265610 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Apr 6, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10091.8 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain
Penalties (3 years)
1Fines totaling $15,646

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
26D0900202Life Care Center of Saint Louis3520 Chouteau Avenue, Saint Louis, MO 63103Certificate of waiverApr 18, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Direct Ownership Interest Mar 4, 1993 100%
Corporate OfficerPresident/Board Member Jul 28, 1993
Corporate DirectorPresident/Board Member Feb 1, 1994
Operational/Managerial Control Feb 1, 1994
Joanna J Crooks Individual Corporate OfficerVP/Secretary/Treasurer/Board Mem Aug 19, 2009
Corporate DirectorVP/Secretary/Treasurer/Board Mem Aug 19, 2009
Joan E Thurmond Individual Corporate OfficerAssistant Secretary Aug 1, 2002
Cindy S Cross Individual Corporate OfficerAssistant Secretary Jul 28, 1993
Richard Swanker Individual Corporate OfficerChief Tax Officer Apr 1, 2011
Life Care Centers of America, Inc. Organization, Cleveland, TN Operational/Managerial Control Mar 23, 1995 100%

Owners & managing parties with NPI records 25

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 25

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners & affiliated clinicians

Practitioners 2

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783900800000",
    "number": "1063469765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 CHOUTEAU AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032916",
            "telephone_number": "314-771-2100",
            "fax_number": "314-771-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C.M.C. EXTENDED CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "31339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of St. Louis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.