Organization Active NPI

Cameron No 1 Inc

Doing business as Quail Run Health Care Center

  • Skilled Nursing Facility
  • Cameron, MO
National Provider Identifier
1194757112
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
046603 Issued in MO
Legal business name
CAMERON NO 1 INC
Doing business as
Quail Run Health Care Center
Practice address
1405 W Grand Ave
Cameron, MO 64429
Phone
(816) 632-2151
Fax
(816) 632-2999
NPI assigned
Jul 7, 2006
Last updated
Aug 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Authorized official

Name
Donald B Bedell
Title
President
Phone
(573) 471-1276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 046603 MO Primary

Addresses

Primary practice location

1405 W Grand Ave
Cameron, MO 64429

Mailing address

PO Box 1210
Sikeston, MO 63801-1210
Phone (573) 471-1276

Other identifiers 1

IdentifierTypeStateIssuer
101455905MedicaidMO

Other names 1

  • Quail Run Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050622000178 MO Part A Provider - Skilled Nursing Facility 4587609409 Practice locations: Cameron, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194757112. Details of each certification follow.

Skilled nursing facility certification: CCN 265353

Legal name
CAMERON NO 1 INC
Doing business as
QUAIL RUN HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1989
Last certification
Nov 7, 2024
Beds
84
Ownership / control type
Individual
Organization structure
CorporationProprietary
Enrollment address
1405 W Grand Ave
Cameron, MO 64429-1118
Nursing home name
QUAIL RUN HEALTH CARE CENTER
Affiliated entity
CIRCLE B ENTERPRISES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Quail Run Health Care CenterCCN 265353 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Mar 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8457.0 residents per day on average
Chain
Circle B Enterprises36 facilities in the chain

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
26D0897397Quail Run Health Care Center1405 W Grand Ave, Cameron, MO 64429Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Laeeq a Tahirkheli Individual Operational/Managerial Control Dec 1, 2020
Adp of the SNF Dec 10, 2020
Sovereign Healthcare Group LLC Organization, Sikeston, MO LLC, Medical provider/supplier Operational/Managerial Control Apr 23, 2021
Adp of the SNF Apr 6, 2025
FG LLC Organization, Sikeston, MO LLC Adp of the SNF Dec 2, 2016
Mid States Inc Organization, Sikeston, MO Corporation, Management services company Adp of the SNF Nov 1, 2010
Individual Adp of the SNF Jan 1, 2000
Van de Ven LLC Organization, Cape Girardeau, MO LLC Adp of the SNF Jan 1, 2000
Circle B Enterprises Holding Company Inc Organization, Sikeston, MO Corporation, Holding company 5% Or Greater Direct Ownership Interest Jan 1, 1996 100%
Todd Beaird Individual Corporate OfficerCorporate Secretary Jan 1, 2022
Adp of the SNF Jan 1, 2022
Donald B Bedell Individual Corporate OfficerPresident Jan 1, 1996 100%
Corporate DirectorPresident Jan 1, 2001
Operational/Managerial Control Jan 1, 1996
Individual Adp of the SNF Jan 1, 2000
Travis Heldenbrand Individual Operational/Managerial Control Jun 3, 2026
Adp of the SNF Jun 3, 2026
DCB Real Estate Partnership LP Organization, Sikeston, MO Adp of the SNF Apr 11, 2025
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Adp of the SNF Aug 16, 2021
Cameron Development Properties LLC Organization, Sikeston, MO LLC Adp of the SNF Jan 1, 2010
Agh1 LLC Organization, Sikeston, MO LLC, Management services company, Consulting firm Operational/Managerial Control Dec 2, 2016
Adp of the SNF Mar 25, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 41

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

View all 41

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1194757112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011210",
            "telephone_number": "573-471-1276",
            "fax_number": "573-472-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 W GRAND AVE",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "64429",
            "telephone_number": "816-632-2151",
            "fax_number": "816-632-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMERON NO 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-08-24",
        "status": "A",
        "authorized_official_last_name": "BEDELL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "046603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101455905",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quail Run Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quail Run Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cameron, MO

Sources for this page

Verify at the official NPI Registry.