NPIMap

Organization Active NPI

N & R of Hermitage LLC

  • Skilled Nursing Facility
  • Hermitage, MO
National Provider Identifier
1235536301
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
041318 Issued in MO
Legal business name
N & R OF HERMITAGE LLC
Practice address
18599 First Street
Hermitage, MO 65668-0325
Phone
(417) 745-2111
Fax
(417) 745-2211
NPI assigned
Dec 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Authorized official

Name
Carla Hedrick, CFO
Title
Cfo
Phone
(573) 481-9625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 041318 MO Primary

Addresses

Primary practice location

18599 First Street
Hermitage, MO 65668-0325

Mailing address

PO Box 325
Hermitage, MO 65668-0325
Phone (417) 745-2111

Other identifiers 1

IdentifierTypeStateIssuer
101975308MedicaidMO

Other names 1

  • HERMITAGE NURSING & REHAB Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 199.119.81.30:8291 Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150109000573 MO Part A Provider - Skilled Nursing Facility 1658695143 Practice locations: Hermitage, MO

Skilled nursing facility certification: CCN 265239

Legal name
N & R OF HERMITAGE LLC
Doing business as
HERMITAGE NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 2, 1984
Last certification
Feb 1, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Dec 1, 2014 in MO
Enrollment address
18599 First St
PO Box 325
Hermitage, MO 65668-9129
Nursing home name
HERMITAGE NURSING & REHAB
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hermitage Nursing & RehabCCN 265239
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 2, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12064.3 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $78,550

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Christian Health and Rehabilitation of Hermitage2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Jaquelyne a Spence Individual W-2 Managing EmployeeAdministrator Apr 25, 2022 100%
LTC Management Services LLC Organization, Sikeston, MO Management services company Operational/Managerial Control Dec 1, 2014 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Dec 1, 2014 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Dec 1, 2014 50%

Facilities with the same owner 36

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

View all 36

Practitioners & affiliated clinicians

Practitioners 4

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

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": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1235536301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680325",
            "telephone_number": "417-745-2111",
            "fax_number": "417-745-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18599 FIRST STREET",
            "city": "HERMITAGE",
            "state": "MO",
            "postal_code": "656680325",
            "telephone_number": "417-745-2111",
            "fax_number": "417-745-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N & R OF HERMITAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-481-9625",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "041318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101975308",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "199.119.81.30:8291",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 w 108th ter",
            "city": "overland park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HERMITAGE NURSING & REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermitage, MO

Sources for this page

Verify at the official NPI Registry.