St. Josephs Villa Inc
Organization Active NPI Skilled Nursing Facility · David City, NE
NPI 1104823046 · NPPES record last updated Nov 9, 2016
Key facts
- NPI
- 1104823046
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 094002 (NE)
- Legal business name
- ST. JOSEPHS VILLA INC
- Practice address
- 927 N 7TH St
David City, NE 68632 - Phone
- (402) 367-3045
- Fax
- (402) 367-3730
- NPI assigned
- Jul 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Sandra K Palmer
- Title
- Administrator
- Phone
- (402) 367-3045
Owners & managing parties with NPI records 1
-
Robert Austin Daro, M.D.
Facilities with the same owner 9
Practitioners 1
-
Robert Austin Daro, M.D.
Affiliated clinicians 1
-
Robert Austin Daro, M.D.
Medicare Care Compare: Nursing home
- Listed as
- St. Joseph's Villa, Inc.
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jan 1, 2003
- Medicare certification status
- Active
- Certified beds
- 58 · 54.9 residents per day on average
- Chain
- Rural Health Development
- Penalties (3 years)
- 2 · fines totaling $27,115
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 28D0681883 | St Joseph Villa Inc | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Skilled nursing facility certification: CCN 285249
- Legal name
- ST JOSEPHS VILLA INC
- Doing business as
- ST JOSEPHS VILLA INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 2003
- Last certification
- Sep 4, 2024
- Beds
- 58
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 927 N 7TH St
David City, NE 68632-1398 - Nursing home name
- ST. JOSEPH'S VILLA, INC.
- Affiliated entity
- RURAL HEALTH DEVELOPMENT
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Kenneth Polacek |
Corporate Officer |
Dec 13, 2016 | |
| Robert Austin Daro |
Operational/Managerial Control | Dec 27, 2019 | |
| Adp of the SNF | May 21, 2025 | ||
| |
Adp of the SNF | Apr 25, 2025 | |
| Jeanne Jakub |
Corporate Officer |
Oct 12, 2021 | |
| Allen Moravec |
Corporate Officer |
Dec 13, 2016 | |
| Frances Pytlik |
Corporate Officer |
Jul 1, 2003 | |
| Managing Control - Governing Body |
Jul 1, 2003 | ||
| Matthew R Ross |
Operational/Managerial Control | Jul 14, 2008 | |
| Adp of the SNF | Jul 14, 2008 | ||
| Indirect Ownership Interest | Apr 17, 2025 | ||
| Jackie S Hoeft |
Corporate Officer |
Oct 12, 2021 | |
| Christina Shannon |
Operational/Managerial Control | Jan 17, 2025 | |
| Adp of the SNF | Jan 17, 2025 | ||
| Laura M Kobza |
Corporate Director | Dec 8, 2015 | |
| Ron D Ross |
Operational/Managerial Control | Jul 14, 2008 | |
| Adp of the SNF | Jul 14, 2008 | ||
| Gary Meister |
Corporate Officer |
Oct 1, 2023 | |
| Susan M Birkel |
Corporate Officer | Oct 12, 2021 | |
| Rural Health Development Inc. |
Operational/Managerial Control | Jul 14, 2008 | |
| Adp of the SNF | Apr 25, 2025 | ||
| Michael Adamy |
Corporate Officer |
Feb 14, 2017 | |
| Vicki Lepant |
Adp of the SNF | Jul 14, 2008 | |
| |
Adp of the SNF | Jan 1, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120210000397 | NE | Part a Provider - Skilled Nursing Facility | 1759299779 | Practice locations: David City, NE |
National Provider Directory
Locations
927 N 7th St
David City, NE 68632
Phone (402) 367-3045
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 094002 | NE | Yes |
Addresses
Primary practice location
927 N 7TH St
David City, NE 68632
Mailing address
927 N 7TH St
David City, NE 68632
Phone (402) 367-3045
Other names
- St Joseph's Villa and Court
Other providers in David City, NE
- Rebekah Roh
- Steven Saalfeld
- Tasha K Saunders
- Kristin D Scheele
- Cynthia Snyder
- Shannon Marie Stemple
- Margaret Struck
- Matthew Paul Summers
- Joshua Sypal
- Karla J Syring Brezina
All providers in David City, NE · Skilled Nursing Facility in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.