Active NPI
American Nursing & Rehab LLC
Doing business as ST Joe Manor
- Skilled Nursing Facility
- Bonne Terre, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- AMERICAN NURSING & REHAB LLC
- Doing business as
- ST Joe Manor
- Practice address
- 10 Lake Drive
Bonne Terre, MO 63628-1820 - Phone
- (573) 358-2800
- NPI assigned
- Jan 30, 2020
- Last updated
- Mar 23, 2026
- 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. Shafiq Malik
- Title
- Owner
- Phone
- (573) 335-3044
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
10 Lake Drive
Bonne Terre, MO 63628-1820
Mailing address
2215 Broadway St
Cape Girardeau, MO 63701
Phone (573) 335-3044
Other names 1
- ST Joe Manor
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200129002585 | MO | Part A Provider - Skilled Nursing Facility | 4880020478 | Practice locations: Bonne Terre, MO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1093346975. Details of each certification follow.
Skilled nursing facility certification: CCN 265701
- Legal name
- AMERICAN NURSING & REHAB LLC
- Doing business as
- ST JOE MANOR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 12, 1999
- Last certification
- Feb 13, 2025
- Beds
- 155
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- AMERICAN NURSING AND REHAB
- Organization structure
- LLC
- Enrollment address
- 10 Lake Dr
Bonne Terre, MO 63628-1820 - Nursing home name
- ST JOE MANOR
- Affiliated entity
- SHAFIQ MALIK
Care Compare: Nursing home
Medicare Care Compare- Listed as
- St Joe Manor
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 12, 1999
- Medicare certification status
- Active
- Certified beds
- 155
- Chain
- Shafiq Malik
National Provider Directory
National Provider Directory- Tax ID family
- American Nursing Rehab LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Bonne Terre, MO
- NPI 1255964508
Ownership & related parties
All disclosed owners & managing parties 5
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 |
|---|---|---|---|
| Omer Malik | 5% Or Greater Direct Ownership Interest | Nov 19, 2019 | 50% |
| Corporate Officer | Nov 19, 2019 | ||
| Operational/Managerial Control | Nov 19, 2019 | ||
| Adp of the SNF | Nov 19, 2019 | ||
| Sharon Greco | Operational/Managerial Control | Feb 1, 2020 | |
| Adp of the SNF | Apr 25, 2025 | ||
| Forvis Mazars LLP | Adp of the SNF | Oct 1, 2009 | |
| Guy D Roberts | Operational/Managerial Control | Feb 1, 2020 | |
| Adp of the SNF | Sep 11, 2025 | ||
| Shafiq Malik | 5% Or Greater Direct Ownership Interest | Nov 19, 2019 | 50% |
| Corporate Officer | Nov 19, 2019 | ||
| Operational/Managerial Control | Nov 19, 2019 | ||
| Adp of the SNF | Nov 19, 2019 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Farmington, MO
- NPI 1528085156
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 6
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
- De Soto, MO
- NPI 1548266737
-
- Family Medicine Physician
- Potosi, MO
- NPI 1578056800
-
- Emergency Medicine Physician
- Perryville, MO
- NPI 1891759221
-
- Family Medicine Physician
- Desloge, MO
- NPI 1932193554
-
- Family Medicine Physician
- Farmington, MO
- NPI 1154373017
-
- Family Medicine Physician
- Farmington, MO
- NPI 1528085156
Affiliated clinicians 5
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": "1580342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1774224000000",
"number": "1093346975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 BROADWAY ST",
"city": "CAPE GIRARDEAU",
"state": "MO",
"postal_code": "63701",
"telephone_number": "573-335-3044",
"fax_number": "573-335-6724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 LAKE DRIVE",
"city": "BONNE TERRE",
"state": "MO",
"postal_code": "636281820",
"telephone_number": "573-358-2800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMERICAN NURSING & REHAB LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-01-30",
"last_updated": "2026-03-23",
"certification_date": "2026-03-23",
"status": "A",
"authorized_official_last_name": "MALIK",
"authorized_official_first_name": "SHAFIQ",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "573-335-3044",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ST Joe Manor",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bonne Terre, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.