NPIMap

Organization Active NPI

Hubble Creek, LLC

  • Skilled Nursing Facility
  • Jackson, MO
National Provider Identifier
1083600340
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
031404 Issued in MO
Legal business name
HUBBLE CREEK, LLC
Practice address
1115 K Land Drive
Jackson, MO 63755
Phone
(573) 243-8989
Fax
(573) 243-6836
NPI assigned
Sep 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Ben Pack Sells
Title
Ceo
Phone
(573) 703-3049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 031404 MO Primary

Addresses

Primary practice location

1115 K Land Drive
Jackson, MO 63755

Mailing address

300 N Walnut St Ste a
Dexter, MO 63841-1748
Phone (573) 614-7472

Other identifiers 2

IdentifierTypeStateIssuer
105214902MedicaidMO
16950101OtherMOSTATE ID

Other names 1

  • Monticello House Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Pointclickcare.com Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250915001886 MO Part A Provider - Skilled Nursing Facility 4587167481 Practice locations: Jackson, MO

Skilled nursing facility certification: CCN 265716

Legal name
HUBBLE CREEK LLC
Doing business as
HUBBLE CREEK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 14, 2001
Last certification
Nov 8, 2024
Beds
105
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
1115 K Land Dr
Jackson, MO 63755-2588
Nursing home name
HUBBLE CREEK
Affiliated entity
PARADIGM SENIOR MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hubble CreekCCN 265716
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 14, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10562.2 residents per day on average
Chain
Paradigm Senior Management8 facilities in the chain
Ownership change
Changed ownership in the last 12 months

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

300 N Walnut St
#A
Dexter, MO 63841

1115 K Land Dr
Jackson, MO 63755
Phone (573) 243-3101

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
MRV Banks Organization, Cape Girardeau, MO Corporation, Financial institution 5% Or Greater Security Interest Sep 1, 2025 100%
Adp of the SNF Sep 1, 2025
Benjamin P Sells Individual Operational/Managerial Control Sep 1, 2025
Direct Ownership Interest Sep 1, 2025 50%
Jenny M Eichhorn Individual Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
Layne Vanek Individual Operational/Managerial Control Sep 1, 2025
Angela R Jones Individual Operational/Managerial Control Sep 1, 2025
Direct Ownership Interest Sep 1, 2025 50%
Paradigm Senior Management LLC Organization, Dexter, MO LLC, For-profit, Chain home office Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
Mindy Clay Individual Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
Jackson Care Center LLC Organization, Sikeston, MO LLC, For-profit Adp of the SNF Apr 27, 2016
Dalen Hutchinson Individual Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
Forvis Mazars LLP Organization, Springfield, MO Consulting firm, For-profit Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025
Paradigm Rehab Services LLC Organization, Dexter, MO LLC, Medical provider/supplier, For-profit Operational/Managerial Control Sep 1, 2025
Adp of the SNF Sep 1, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 87

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

View all 87

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1768176000000",
    "number": "1083600340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N WALNUT ST STE A",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638411748",
            "telephone_number": "573-614-7472",
            "fax_number": "573-243-6836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 K LAND DRIVE",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "63755",
            "telephone_number": "573-243-8989",
            "fax_number": "573-243-6836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUBBLE CREEK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "SELLS",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "PACK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-703-3049"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105214902",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "16950101",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pointclickcare.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Point Click Care",
            "address_1": "1115 K Land Dr",
            "city": "Jackson",
            "state": "MO",
            "country_code": "US",
            "postal_code": "637552588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Monticello House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MO

Sources for this page

Verify at the official NPI Registry.