NPIMap

Organization Active NPI

Bleauridge Nursing and Rehab LLC

Doing business as Beautiful Savior Nursing Home

  • Skilled Nursing Facility
  • Belton, MO
National Provider Identifier
1245068154
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BLEAURIDGE NURSING AND REHAB LLC
Doing business as
Beautiful Savior Nursing Home
Practice address
1003 Cedar St
Belton, MO 64012
Phone
(816) 331-0781
NPI assigned
Jul 23, 2024
Last updated
Jul 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Mr. Shafiq Malik
Title
President
Phone
(573) 335-3044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1003 Cedar St
Belton, MO 64012

Mailing address

2215 Broadway St
Cape Girardeau, MO 63701-4403
Phone (573) 335-3044

Other names 1

  • Beautiful Savior Nursing Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241104002199 MO Part A Provider - Skilled Nursing Facility 9537692165 Practice locations: Belton, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245068154. Details of each certification follow.

Skilled nursing facility certification: CCN 265782

Legal name
BLEAURIDGE NURSING AND REHAB LLC
Doing business as
BEAUTIFUL SAVIOR HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 26, 2004
Last certification
Dec 13, 2024
Beds
126
Ownership / control type
Limited Liability Corporation
Multi-facility organization
MALIK CORPORATION
Most recent change of ownership
Aug 30, 2024
Organization structure
LLCProprietary
Enrollment address
1003 S Cedar St
Belton, MO 64012-3703
Nursing home name
BEAUTIFUL SAVIOR HOME
Affiliated entity
SHAFIQ MALIK

Care Compare: Nursing home

Medicare Care Compare
Listed as
Beautiful Savior HomeCCN 265782 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 26, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12679.3 residents per day on average
Chain
Shafiq Malik9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Bleauridge Nursing and Rehab LLC2 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.

Locations

2215 Broadway St
Cpe Girardeau, MO 63701
Phone (573) 271-5311

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
Omer Malik Individual 5% Or Greater Direct Ownership InterestOwner Aug 30, 2024 50%
Operational/Managerial Control Dec 18, 2024
Adp of the SNF Dec 18, 2024
Forvis Mazars LLP Organization, Springfield, MO Consulting firm, For-profit Operational/Managerial Control Aug 30, 2024
Adp of the SNF Aug 30, 2024
Jennifer Smith Individual Operational/Managerial Control Aug 30, 2024
Adp of the SNF Aug 30, 2024
Brian Haas Individual Corporate DirectorMedical Director Aug 30, 2024
Adp of the SNF Apr 2, 2025
Shafiq Malik Individual 5% Or Greater Direct Ownership InterestOwner Aug 30, 2024 50%
Operational/Managerial Control Aug 30, 2024
Adp of the SNF Aug 30, 2024
Bleauridge Nursing and Rehab LLC Organization, Cape Girardeau, MO Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 30, 2024
Operational/Managerial Control Aug 30, 2024
Adp of the SNF Aug 30, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 87

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

View all 87

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": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1245068154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 BROADWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014403",
            "telephone_number": "573-335-3044",
            "fax_number": "573-335-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 CEDAR ST",
            "city": "BELTON",
            "state": "MO",
            "postal_code": "64012",
            "telephone_number": "816-331-0781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLEAURIDGE NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "SHAFIQ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-335-3044",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beautiful Savior Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belton, MO

Sources for this page

Verify at the official NPI Registry.