The Estates of St. Louis, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE ESTATES OF ST. LOUIS, LLC

Practice address

2115 Kappel Dr
Saint Louis, MO 63136-4115

Phone

(314) 867-7474

NPI assigned

Oct 21, 2014

Last updated

Oct 22, 2014By 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

Tuviyah Spector

Title

Managing Member

Phone

(773) 322-0387

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184028029. Details of each certification follow.

• CCN 265712 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265712

Legal name

THE ESTATES OF ST LOUIS LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 12, 2001

Last certification

Dec 23, 2024

Beds

94

Ownership / control type

Limited Liability Corporation

Multi-facility organization

MEDALLION HEALTHCARE LLC

Most recent change of ownership

Nov 1, 2014

Organization structure

LLCProprietary

Enrollment address

2115 Kappel Dr
Saint Louis, MO 63136-4115

Nursing home name

ESTATES OF ST LOUIS, LLC, THE

Listed as

Estates of St Louis, LLC, theCCN 265712 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jan 12, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9476.3 residents per day on average

Penalties (3 years)

1Fines totaling $66,640

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

Locations

All disclosed owners & managing parties 8

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 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Shawn Michael Gao, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1740424704

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 5

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.

• Zahirul Haque, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1578536546
  NPD (past)
• Christopher T. Labonte, MD

  • Internal Medicine Physician
  • Town and Country, MO
  • NPI 1093813099
  NPD (past)
• Manuel Le-Yeng San, D.O.

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1245443548
  NPD (past)
• Charles Sutherland, DO

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1619945300
  NPD (past)
• Lawrence Wells, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1669430112
  NPD (past)

Affiliated clinicians 3

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

• Mai Tran Hunt, M.D.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1861464158

  Nursing home

  Care Compare affiliation
• Manuel Le-Yeng San, D.O.

  • Family Medicine Physician
  • Columbia, MO
  • NPI 1245443548

  Nursing home

  Care Compare affiliation
• Lawrence Wells, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1669430112

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1184028029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 W GREENLEAF AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606452915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 KAPPEL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631364115",
            "telephone_number": "314-867-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ESTATES OF ST. LOUIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "SPECTOR",
        "authorized_official_first_name": "TUVIYAH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "773-322-0387"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Saint Louis, MO
• Providers in Saint Louis, 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 Oct 22, 2014; 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.