Organization Active NPI

St. Josephs Villa Inc

Doing business as St Joseph's Villa and Court

  • Skilled Nursing Facility
  • David City, NE
National Provider Identifier
1104823046
Registry record updated Nov 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
094002 Issued in NE
Legal business name
ST. JOSEPHS VILLA INC
Doing business as
St Joseph's Villa and Court
Practice address
927 N 7TH St
David City, NE 68632
Phone
(402) 367-3045
Fax
(402) 367-3730
NPI assigned
Jul 7, 2005
Last updated
Nov 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2016

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

Authorized official

Name
Sandra K Palmer
Title
Administrator
Phone
(402) 367-3045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 094002 NE Primary

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 1

  • St Joseph's Villa and Court Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120210000397 NE Part A Provider - Skilled Nursing Facility 1759299779 Practice locations: David City, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104823046. Details of each certification follow.

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
CorporationNon-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

Care Compare: Nursing home

Medicare Care Compare
Listed as
St. Joseph's Villa, Inc.CCN 285249 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
5854.9 residents per day on average
Chain
Rural Health Development9 facilities in the chain
Penalties (3 years)
2Fines totaling $27,115

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
28D0681883St Joseph Villa Inc927 7TH St, David City, NE 68632Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

927 N 7th St
David City, NE 68632
Phone (402) 367-3045

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Kenneth Polacek Individual Corporate OfficerBoardmember Dec 13, 2016
Robert Austin Daro Individual Operational/Managerial Control Dec 27, 2019
Adp of the SNF May 21, 2025
Organization, Grand Island, NE Corporation Adp of the SNF Apr 25, 2025
Jeanne Jakub Individual Corporate OfficerBoard Member Oct 12, 2021
Allen Moravec Individual Corporate OfficerBoardmember Dec 13, 2016
Frances Pytlik Individual Corporate OfficerPresident Jul 1, 2003
Managing Control - Governing BodyPresident Jul 1, 2003
Matthew R Ross Individual Operational/Managerial Control Jul 14, 2008
Adp of the SNF Jul 14, 2008
Indirect Ownership Interest Apr 17, 2025
Jackie S Hoeft Individual Corporate OfficerBoard Member Oct 12, 2021
Christina Shannon Individual Operational/Managerial Control Jan 17, 2025
Adp of the SNF Jan 17, 2025
Laura M Kobza Individual Corporate Director Dec 8, 2015
Ron D Ross Individual Operational/Managerial Control Jul 14, 2008
Adp of the SNF Jul 14, 2008
Gary Meister Individual Corporate OfficerBoard Member Oct 1, 2023
Susan M Birkel Individual Corporate Officer Oct 12, 2021
Rural Health Development Inc. Organization, Cambridge, NE Corporation, Management services company, Consulting firm, For-profit Operational/Managerial Control Jul 14, 2008
Adp of the SNF Apr 25, 2025
Michael Adamy Individual Corporate OfficerBoardmember Feb 14, 2017
Vicki Lepant Individual Adp of the SNF Jul 14, 2008
Individual Adp of the SNF Jan 1, 2023

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 9

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

Practitioners & affiliated clinicians

Practitioners 1

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 1

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1104823046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 N 7TH ST",
            "city": "DAVID CITY",
            "state": "NE",
            "postal_code": "68632",
            "telephone_number": "402-367-3045",
            "fax_number": "402-367-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 N 7TH ST",
            "city": "DAVID CITY",
            "state": "NE",
            "postal_code": "68632",
            "telephone_number": "402-367-3045",
            "fax_number": "402-367-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPHS VILLA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-367-3045"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "094002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Joseph's Villa and Court",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in David City, NE

Sources for this page

Verify at the official NPI Registry.