Clark County Nursing Home

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

035239 Issued in MO

Legal business name

CLARK COUNTY NURSING HOME

Practice address

1260 N Johnson St
Kahoka, MO 63445-1100

Phone

(660) 727-3303

Fax

(660) 727-3736

NPI assigned

Aug 26, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Tammy McDaniel-Ramsey, R.N.

Title

Administrator

Phone

(660) 727-3303

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Skilled nursing facility certification: CCN 265485

Legal name

CLARK COUNTY NURSING HOME

Doing business as

CLARK COUNTY NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 30, 1992

Last certification

Jan 29, 2025

Beds

103 (99 certified)

Ownership / control type

County

Organization structure

OtherProprietary

Enrollment address

1260 N Johnson St
Kahoka, MO 63445-1100

Nursing home name

CLARK COUNTY NURSING HOME

Listed as

Clark County Nursing HomeCCN 265485

Overall star rating

2 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Jan 30, 1992

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

9953.9 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 5

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.

• Jeffrey D Davis, DO

  • Family Medicine Physician
  • Memphis, MO
  • NPI 1679558589

  Adp of the SNF

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey D Davis, DO

  • Family Medicine Physician
  • Memphis, MO
  • NPI 1679558589
  NPD (past)

Affiliated clinicians 4

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

• Kelsey M Davis-Humes, D.O

  • Family Medicine Physician
  • Memphis, MO
  • NPI 1457701419

  Nursing home

  Care Compare affiliation
• Jeffrey D Davis, DO

  • Family Medicine Physician
  • Memphis, MO
  • NPI 1679558589

  Nursing home

  Care Compare affiliation
• Brittany Egley

  • Family Nurse Practitioner
  • Kahoka, MO
  • NPI 1114457330

  Nursing home

  Care Compare affiliation
• Michael Todd Duzan, DO

  • Family Medicine Physician
  • Pueblo, CO
  • NPI 1124086723

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1194718908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N JOHNSON ST",
            "city": "KAHOKA",
            "state": "MO",
            "postal_code": "634451100",
            "telephone_number": "660-727-3303",
            "fax_number": "660-727-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N JOHNSON ST",
            "city": "KAHOKA",
            "state": "MO",
            "postal_code": "634451100",
            "telephone_number": "660-727-3303",
            "fax_number": "660-727-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK COUNTY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL-RAMSEY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-727-3303",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "035239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101483709",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261483705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blessing Hospital
• Jessica Dianne Boudreau, COTA/L
• Stacia N. Briscoe, CNP
• Brittany Thornburg
• Clark County Ambulance District
• Clark County Nursing Service & Home Health Agency
• Clark County Nursing Service & Home Health Agency
• Clark County Nursing Service & Home Health Agency
• Clark County Nursing Service & Home Health Agency
• Clark County Pharmacy Inc

• Skilled Nursing Facility in Kahoka, MO
• Providers in Kahoka, 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 Jul 31, 2009; 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.