Granby No 1 Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

044835 Issued in MO

Legal business name

GRANBY NO 1 INC

Doing business as

Granby House

Practice address

301 S Main St
Granby, MO 64844-8336

Phone

(417) 472-6271

NPI assigned

Jul 7, 2006

Last updated

Aug 31, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donald B Bedell

Title

President

Phone

(573) 471-1276

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Granby House Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073545067. Details of each certification follow.

• CCN 265468 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265468

Legal name

GRANBY NO 1 INC

Doing business as

GRANBY HOUSE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Sep 23, 1991

Last certification

Jun 27, 2024

Beds

60

Ownership / control type

Corporation

Multi-facility organization

GRANBY 1 INC

Organization structure

CorporationProprietary

Enrollment address

301 S Main St
Granby, MO 64844-8336

Nursing home name

GRANBY HOUSE

Affiliated entity

CIRCLE B ENTERPRISES

Listed as

Granby HouseCCN 265468 · All quality measures

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Sep 23, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6053.7 residents per day on average

Chain

Circle B Enterprises36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 2

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

• Sovereign Healthcare Group, LLC

  • Home Health Agency
  • New Madrid, MO
  • NPI 1447821418

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Cheryl G Williams, D.O.

  • Family Medicine Physician
  • Mount Vernon, MO
  • NPI 1730187204

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 41

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

• Ava No 1 Inc

  • Skilled Nursing Facility
  • Ava, MO
  • NPI 1518999515

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Boonville No 1 Inc

  dba Lakeview Health Care & Rehabilitation Center

  • Skilled Nursing Facility
  • Boonville, MO
  • NPI 1295767275

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Boonville No2 Inc

  dba Riverdell Care Center

  • Skilled Nursing Facility
  • Boonville, MO
  • NPI 1740212760

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Cameron No 1 Inc

  dba Quail Run Health Care Center

  • Skilled Nursing Facility
  • Cameron, MO
  • NPI 1194757112

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Cape Girardeau I Inc

  dba Heartland Care & Rehabilitation Center

  • Skilled Nursing Facility
  • Cape Girardeau, MO
  • NPI 1649202623

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Caruthersville No 1 Inc

  dba Southgate Living Center

  • Skilled Nursing Facility
  • Caruthersville, MO
  • NPI 1457708018

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Clinton No 1 Inc

  • Skilled Nursing Facility
  • Clinton, MO
  • NPI 1033141015

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Clinton No 2 Inc

  dba Adair Village

  • Skilled Nursing Facility
  • Clinton, MO
  • NPI 1548913288

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Collins Acres Care Center Inc

  dba Sikeston Convalescent Center

  • Skilled Nursing Facility
  • Sikeston, MO
  • NPI 1912939976

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Delhaven Manor No 2 Inc

  dba Delhaven Manor

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1750313730

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Ellington 1 Inc

  dba Brent B Tinnin Manor

  • Skilled Nursing Facility
  • Ellington, MO
  • NPI 1629000690

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Excelsior Spring 1 Inc

  dba Valley Manor & Rehabilitation Center

  • Skilled Nursing Facility
  • Excelsior Springs, MO
  • NPI 1265464234

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership

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.

• Fernando Cavero, M.D.

  • Internal Medicine Physician
  • Sparta, MO
  • NPI 1669545711
  NPD (past)
• Cheryl G Williams, D.O.

  • Family Medicine Physician
  • Mount Vernon, MO
  • NPI 1730187204
  NPD (past)

Affiliated clinicians 1

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

• Fernando Cavero, M.D.

  • Internal Medicine Physician
  • Sparta, MO
  • NPI 1669545711

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504137600000",
    "number": "1073545067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MAIN ST",
            "city": "GRANBY",
            "state": "MO",
            "postal_code": "648448336",
            "telephone_number": "417-472-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANBY NO 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-08-31",
        "status": "A",
        "authorized_official_last_name": "BEDELL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "044835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103045605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granby House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casey D Cox
• East Newton Co R-VI
• Heather Diane Eckhart, MSW, LCSW
• Summer Alaina Enlow
• Granby Family Clinic LLC
• William David Hosp
• Ashley B Jentink, COTA/L
• Rachel Jobe, IBCLC
• Shana C Perez, M. S. CCC-SLP
• Stacie Savage, MS RDN LDN

• Skilled Nursing Facility in Granby, MO
• Providers in Granby, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.

Verify at the official NPI Registry.