Coffman-Levi Charitable Trust, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

324001 Issued in NE

Legal business name

COFFMAN-LEVI CHARITABLE TRUST, INC

Practice address

200 Levi LN
Adams, NE 68301-8830

Phone

(402) 988-7115

Fax

(402) 988-2111

NPI assigned

Aug 29, 2005

Last updated

Jun 8, 2015By 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

Jeffrey Scott Fritzen

Title

Executive Director

Phone

(402) 988-7115

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gold Crest Retirement Center Other name

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164415816. Details of each certification follow.

• CCN 285065 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 285065

Legal name

COFFMAN-LEVI CHARITABLE TRUST, INC

Doing business as

GOLD CREST RETIREMENT CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jun 7, 1984

Last certification

Mar 12, 2025

Beds

52

Ownership / control type

Other Nonprofit

Organization structure

CorporationNon-profit

Incorporated

Aug 25, 1988 in NE

Enrollment address

200 Levi LN
Adams, NE 68301-8830

Nursing home name

GOLD CREST RETIREMENT CENTER

Listed as

Gold Crest Retirement CenterCCN 285065 · All quality measures

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Jun 7, 1984

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5236.5 residents per day on average

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 6

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

Practitioners 4

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.

• William E Coady, MD

  • Family Medicine Physician
  • Lincoln, NE
  • NPI 1386651941
  NPD (past)
• Elizabeth A Gobber, PA-C

  • Medical Physician Assistant
  • Tecumseh, NE
  • NPI 1063429660
  NPD (past)
• Stacey D. Goodrich, M.D.

  • Family Medicine Physician
  • Tecumseh, NE
  • NPI 1578570180
  NPD (past)
• Zachariah E. Tempelmeyer, M.D.

  • Family Medicine Physician
  • Tecumseh, NE
  • NPI 1487660601
  NPD (past)

Affiliated clinicians 3

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

• Grant Saltzgaber

  • Family Medicine Physician
  • Tecumseh, NE
  • NPI 1881259646

  Nursing home

  Care Compare affiliation
• Sara J Sharples, PA-C

  • Physician Assistant
  • Tecumseh, NE
  • NPI 1760623359

  Nursing home

  Care Compare affiliation
• Zachariah E. Tempelmeyer, M.D.

  • Family Medicine Physician
  • Tecumseh, NE
  • NPI 1487660601

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1164415816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LEVI LN",
            "city": "ADAMS",
            "state": "NE",
            "postal_code": "683018830",
            "telephone_number": "402-988-7115",
            "fax_number": "402-988-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LEVI LN",
            "city": "ADAMS",
            "state": "NE",
            "postal_code": "683018830",
            "telephone_number": "402-988-7115",
            "fax_number": "402-988-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFMAN-LEVI CHARITABLE TRUST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "FRITZEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "402-988-7115"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "324001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068085111",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gold Crest Retirement Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Adams Rescue Squad
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• Kathleen Ann Bacon
• Sarah Elizabeth Byrne, MOT, OTR/L
• Daniel Freeman Public Schools (Freeman Public Schools)
• Eyecare Specialties PC
• Christle Sue Flink
• Detavion Hickey
• Michelle Marie Jarosz, LMHC

• Skilled Nursing Facility in Adams, NE
• Providers in Adams, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.