Active NPI
Delmar Gardens of Creve Coeur Operating, LLC
Doing business as Delmar Gardens of Creve Coeur
- Skilled Nursing Facility
- Creve Coeur, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 044994
- Legal business name
- DELMAR GARDENS OF CREVE COEUR OPERATING, LLC
- Doing business as
- Delmar Gardens of Creve Coeur
- Practice address
- 850 Country Manor LN
Creve Coeur, MO 63141-6651 - Phone
- (314) 434-5900
- Fax
- (314) 434-3927
- NPI assigned
- Sep 16, 2005
- Last updated
- Mar 13, 2017
- 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
- Mr. Gail Lee Hartmann
- Title
- Treasurer
- Phone
- (636) 733-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 044994 | MO | Primary |
Addresses
Primary practice location
850 Country Manor LN
Creve Coeur, MO 63141-6651
Mailing address
14805 N Outer 40 Rd
Suite 300
Chesterfield, MO 63017-6060
Phone (636) 733-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101484608 | Medicaid | MO |
Other names 1
- Delmar Gardens of Creve Coeur
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050322001058 | MO | Part A Provider - Skilled Nursing Facility | 5193771236 | Practice locations: Creve Coeur, MO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1265427124. Details of each certification follow.
Skilled nursing facility certification: CCN 265343
- Legal name
- DELMAR GARDENS OF CREVE COEUR OPERATING, LLC
- Doing business as
- DELMAR GARDENS OF CREVE COEUR
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 28, 1988
- Last certification
- Sep 20, 2023
- Beds
- 148
- Ownership / control type
- Corporation
- Multi-facility organization
- DELMAR GARDENS ENTERPRISES
- Organization structure
- LLC
- Incorporated
- Mar 7, 2003 in MO
- Enrollment address
- 850 Country Manor LN
Creve Coeur, MO 63141-6651
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Country Villa Wellness & Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Nov 28, 1988
- Medicare certification status
- Active
- Certified beds
- 148
National Provider Directory
National Provider DirectoryLocations
850 Country Manor Ln
Saint Louis, MO 63141
Phone (314) 434-5900
Ownership & related parties
All disclosed owners & managing parties 16
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 |
|---|---|---|---|
| Janice G Bitansky | Other | Nov 30, 2010 | 4.26% |
| Harry Z Goldberg | Other | Nov 30, 2010 | 4.26% |
| Non-Gstfamily Trust Est U/W Israel Goldberg Fbo Diane Fredman | 5% Or Greater Indirect Ownership Interest | Apr 10, 2013 | 5.71% |
| Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara | 5% Or Greater Indirect Ownership Interest | Mar 7, 2003 | 8.04% |
| Delmar Gardens Management Services Inc | Operational/Managerial Control | Apr 1, 2005 | 100% |
| Delmar Gardens Enterprises Inc | 5% Or Greater Direct Ownership Interest | Mar 7, 2003 | 100% |
| Diane G Fredman | Other | Nov 30, 2010 | 4.26% |
| Gabe Grossberg | 5% Or Greater Indirect Ownership Interest | Mar 7, 2003 | 16.33% |
| Corporate Officer | Mar 7, 2003 | ||
| Other | Mar 7, 2003 | ||
| Goldberg-Nom LLC | 5% Or Greater Indirect Ownership Interest | Mar 7, 2003 | 25% |
| Antoine Wiley | W-2 Managing Employee | Jun 12, 2023 | |
| George T Grossberg | 5% Or Greater Indirect Ownership Interest | Mar 7, 2003 | 11.33% |
| Other | Mar 7, 2003 | ||
| Non-GST Family Trust Est U/W of Israel Goldberg Fbo Janice Bitanski | 5% Or Greater Indirect Ownership Interest | Apr 10, 2013 | 5.71% |
| Howard M Oppenheimer | Corporate Officer | Mar 7, 2003 | |
| Other | Mar 7, 2003 | ||
| Kenneth F Marx | Corporate Officer | Jun 11, 2019 | |
| W-2 Managing Employee | May 1, 2022 | ||
| George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara | 5% Or Greater Indirect Ownership Interest | Mar 7, 2003 | 8.04% |
| Non-GST Family Trust Established U/W of Israel Goldberg Fbo Harry Zvi | 5% Or Greater Indirect Ownership Interest | Apr 10, 2013 | 5.71% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Psychiatry Physician
- Saint Louis, MO
- NPI 1033135991
5% Or Greater Indirect Ownership Interest, Other
Facilities with the same owner 16
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Delmar Gardens Home Care
- Home Health Agency
- Chesterfield, MO
- NPI 1295720118
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens North
- Skilled Nursing Facility
- Black Jack, MO
- NPI 1750376612
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Chesterfield
- Skilled Nursing Facility
- Chesterfield, MO
- NPI 1861487712
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Meramec Valley
- Skilled Nursing Facility
- Fenton, MO
- NPI 1013903525
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of O'Fallon
- Skilled Nursing Facility
- O'Fallon, MO
- NPI 1942295803
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens South
- Skilled Nursing Facility
- Saint Louis, MO
- NPI 1659366516
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens on the Green
- Skilled Nursing Facility
- Chesterfield, MO
- NPI 1841285798
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens West
- Skilled Nursing Facility
- Town & Country, MO
- NPI 1043206584
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Pathways Hospice and Palliative Care
- Community Based Hospice Care Agency
- Chesterfield, MO
- NPI 1447245360
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Gwinnett
- Skilled Nursing Facility
- Lawrenceville, GA
- NPI 1255327862
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba Delmar Gardens of Lenexa
- Skilled Nursing Facility
- Lenexa, KS
- NPI 1336134295
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
-
dba St. Joseph Villa
- Skilled Nursing Facility
- Omaha, NE
- NPI 1417942277
Delmar Gardens Enterprises Inc, Delmar Gardens Management Services Inc, Gabe Grossberg and George Grossberg, Trustees of the Henry and Barbara, George Grossberg and Gabe Grossberg, Trustees of the Henry and Barbara, Goldberg-Nom LLC, Non-GST Family T
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1427151323
-
- Internal Medicine Physician
- Saint Louis, MO
- NPI 1114949963
Affiliated clinicians 3
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": "1126828800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1489363200000",
"number": "1265427124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14805 N OUTER 40 RD",
"address_2": "SUITE 300",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630176060",
"telephone_number": "636-733-7000",
"fax_number": "636-733-7010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 COUNTRY MANOR LN",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631416651",
"telephone_number": "314-434-5900",
"fax_number": "314-434-3927"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DELMAR GARDENS OF CREVE COEUR OPERATING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-16",
"last_updated": "2017-03-13",
"status": "A",
"authorized_official_last_name": "HARTMANN",
"authorized_official_first_name": "GAIL",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "636-733-7000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MO",
"license": "044994",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101484608",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Delmar Gardens of Creve Coeur",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Creve Coeur, MO
- Malti Dave, MD
- Jeffery Scott Davis, APN RN
- De Geer Health & Wellness, LLC
- Kourtney Dean, CCC-SLP
- Cindy Decker, LHIS
- Delta Spinal Rehab P.C.
- Joseph Paulson Demosthene, MS, ATC,EMT-B, CPT
- Dental Professionals, Richard Straus, D.M.D., P.C. (Premier Dental Partners West County - Old Ballas Oral Surgery)
- Kayla Detienne
- Rohan Devanpalli-Ramaya, M.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.