Active NPI
City of Imperial
Doing business as Imperial Manor Nursing Home
- Skilled Nursing Facility
- Imperial, NE
National Provider Identifier
1215924428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 134001
- Legal business name
- CITY OF IMPERIAL
- Doing business as
- Imperial Manor Nursing Home
- Practice address
- 933 Grant St
Imperial, NE 69033-3140 - Phone
- (308) 882-5333
- Fax
- (308) 882-4699
- NPI assigned
- Oct 3, 2005
- Last updated
- Apr 8, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sandra Palmer
- Title
- Administrator
- Phone
- (308) 882-5333
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 134001 | NE | Primary |
Addresses
Primary practice location
933 Grant St
Imperial, NE 69033-3140
Mailing address
933 Grant St
PO Box 757
Imperial, NE 69033-3140
Phone (308) 882-5333
Other names 1
- Imperial Manor Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101102000937 | NE | Part A Provider - Skilled Nursing Facility | 6709796477 | Practice locations: Imperial, NE |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1215924428. Details of each certification follow.
Skilled nursing facility certification: CCN 285252
- Legal name
- CITY OF IMPERIAL
- Doing business as
- IMPERIAL MANOR NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Aug 1, 2003
- Last certification
- Oct 10, 2024
- Beds
- 58
- Ownership / control type
- City/County
- Organization structure
- Other
- Enrollment address
- 933 Grant St
Imperial, NE 69033-3140 - Nursing home name
- IMPERIAL MANOR NURSING HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Imperial Manor Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - City/county
- Certified
- Aug 1, 2003
- Medicare certification status
- Active
- Certified beds
- 58
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Heather Salmon | Operational/Managerial Control | Feb 26, 2024 | |
| Adp of the SNF | Feb 26, 2024 | ||
| David G Younger | Adp of the SNF | May 15, 2023 | |
| Roxie L Davidson | Operational/Managerial Control | Mar 1, 2025 | |
| Adp of the SNF | Mar 1, 2025 | ||
| Cathy Belau | Operational/Managerial Control | Feb 1, 2022 | |
| Adp of the SNF | Feb 1, 2022 | ||
| Sabrina Hayes | Operational/Managerial Control | May 15, 2023 | |
| Adp of the SNF | May 15, 2023 | ||
| Nick Colton | Operational/Managerial Control | Apr 1, 2025 | |
| Adp of the SNF | Apr 1, 2025 | ||
| City of Imperial | 5% Or Greater Direct Ownership Interest | Apr 7, 1968 | 100% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Affiliated clinicians 8
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Imperial, NE
- NPI 1871273300
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1365379200000",
"number": "1215924428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 GRANT ST",
"address_2": "PO BOX 757",
"city": "IMPERIAL",
"state": "NE",
"postal_code": "690333140",
"telephone_number": "308-882-5333",
"fax_number": "308-882-4699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 GRANT ST",
"city": "IMPERIAL",
"state": "NE",
"postal_code": "690333140",
"telephone_number": "308-882-5333",
"fax_number": "308-882-4699"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CITY OF IMPERIAL",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-03",
"last_updated": "2013-04-08",
"status": "A",
"authorized_official_last_name": "PALMER",
"authorized_official_first_name": "SANDRA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "308-882-5333"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NE",
"license": "134001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Imperial Manor Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Imperial, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.