Lawrence County Nursing Home District

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

039010 Issued in MO

Legal business name

LAWRENCE COUNTY NURSING HOME DISTRICT

Practice address

915 Carl Allen St
Mount Vernon, MO 65712-1612

Phone

(417) 466-2183

Fax

(417) 466-3003

NPI assigned

Mar 28, 2006

Last updated

Dec 2, 2011By 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

Mrs. Lorena Beth Hill

Title

Administrator

Phone

(417) 466-2183

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104887561. Details of each certification follow.

• CCN 265752 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265752

Legal name

LAWRENCE COUNTY NURSING HOME DISTRICT

Doing business as

LAWRENCE COUNTY MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 1, 2003

Last certification

Sep 22, 2023

Beds

90

Ownership / control type

County

Organization structure

OtherNon-profit

Enrollment address

915 Carl Allen St
Mount Vernon, MO 65712-1612

Nursing home name

LAWRENCE COUNTY MANOR

Listed as

Lawrence County ManorCCN 265752 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Mar 1, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9067.4 residents per day on average

Penalties (3 years)

1Fines totaling $13,762

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

All disclosed owners & managing parties 16

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.

• Midwest Physical Therapy, PC

  dba Mid America Physical Therapy

  • Physical Therapist
  • Unionville, MO
  • NPI 1144389677

  Adp of the SNF

  CMS ownership
• Cheryl G Williams, D.O.

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

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Cheryl G Williams, D.O.

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

Affiliated clinicians 2

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

• William Lewis McKay, DO

  • Family Medicine Physician
  • Mount Vernon, MO
  • NPI 1265417331

  Nursing home

  Care Compare affiliation
• Cheryl G Williams, D.O.

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

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322784000000",
    "number": "1104887561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 CARL ALLEN ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121612",
            "telephone_number": "417-466-2183",
            "fax_number": "417-466-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 CARL ALLEN ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121612",
            "telephone_number": "417-466-2183",
            "fax_number": "417-466-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE COUNTY NURSING HOME DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2011-12-02",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "LORENA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "417-466-2183",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "030910",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031083",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "039010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101489300",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Knight, LMSW
• Billie Knipfer, SLP-CF
• Ethan Kristek, M.S., CCC-SLP
• Landrum Drug Inc (Landrum Drug)
• Lawrence County Health Department
• Vu H Le, M.D.
• Jeffrey Paul Leclair, PSY.D., PA-C
• Melissa Marie Lee, HIS
• Lester E Cox Medical Centers (Mt Vernon Family Health Care)
• Lester E Cox Medical Centers (CoxHealth Center Mt. Vernon)

• Skilled Nursing Facility in Mount Vernon, MO
• Providers in Mount Vernon, 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 Dec 2, 2011; 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.