NPIMap

Organization Active NPI

Faulkton Healthcare Center, Inc

  • Skilled Nursing Facility
  • Faulkton, SD
National Provider Identifier
1194796631
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
10619 Issued in SD
Legal business name
FAULKTON HEALTHCARE CENTER, INC
Practice address
1401 Pearl St
Faulkton, SD 57438-2240
Phone
(605) 598-6214
NPI assigned
Feb 1, 2006
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Howie Groff
Title
President
Phone
(952) 888-2923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10619 SD Primary

Addresses

Primary practice location

1401 Pearl St
Faulkton, SD 57438-2240

Mailing address

1401 Pearl St
Faulkton, SD 57438-2240

Other identifiers 3

IdentifierTypeStateIssuer
0151340MedicaidSD
85084OtherWELLMARK
9571530MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021010000040 SD Part A Provider - Skilled Nursing Facility 6002723681 Practice locations: Faulkton, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194796631. Details of each certification follow.

Skilled nursing facility certification: CCN 435084

Legal name
FAULKTON HEALTHCARE CENTER, INC
Doing business as
FAULKTON SENIOR LIVING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1995
Last certification
Aug 1, 2024
Beds
41
Ownership / control type
Corporation
Multi-facility organization
Tealwood Senior Living
Organization structure
CorporationProprietary
Incorporated
Sep 29, 1997 in MN
Enrollment address
1401 Pearl St
Faulkton, SD 57438-2219
Nursing home name
FAULKTON SENIOR LIVING
Affiliated entity
ACCURA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Faulkton Senior LivingCCN 435084 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 1, 1995
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4139.0 residents per day on average
Chain
Accura Healthcare41 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
43D0690921Faulkton Senior Living1401 Pearl St, Faulkton, SD 57438Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
American Healthcare Management Services LLC Organization, West Des Moines, IA LLC, Management services company Operational/Managerial Control Oct 1, 2019 100%
Brenda Ferguson Individual W-2 Managing EmployeeAdministrator Jan 1, 2023
Ted a Leneave Individual Corporate OfficerCeo Oct 1, 2019
Operational/Managerial ControlPresident Oct 1, 2019 100%
Gail Sheridan Individual 5% Or Greater Indirect Ownership InterestChief Clinical Operations Officer Aug 29, 2008 50%
Corporate Officer Aug 29, 2008
Tealwood Enterprise Inc Organization, Bloomington, MN Corporation, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2012 100%
Howard a Groff Individual 5% Or Greater Indirect Ownership InterestPresident Sep 3, 2008 50%
Corporate Officer Sep 3, 2008

Facilities with the same owner 31

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

View all 31

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 2

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": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1194796631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PEARL ST",
            "city": "FAULKTON",
            "state": "SD",
            "postal_code": "574382240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PEARL ST",
            "city": "FAULKTON",
            "state": "SD",
            "postal_code": "574382240",
            "telephone_number": "605-598-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAULKTON HEALTHCARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "HOWIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-888-2923"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SD",
            "license": "10619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151340",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "85084",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9571530",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Faulkton, SD

Sources for this page

Verify at the official NPI Registry.