Delta South Skilled Nursing and Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

DELTA SOUTH SKILLED NURSING AND REHABILITATION LLC

Practice address

640 Colonel George E Day Parkway
Sikeston, MO 63801-0624

Phone

(573) 471-3400

Fax

(573) 471-4918

NPI assigned

Sep 1, 2016

Last updated

Jul 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bobbie Denise Young

Title

Director of Operations

Phone

(573) 683-1355

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265988950. Details of each certification follow.

• CCN 265862 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265862

Legal name

DELTA SOUTH SKILLED NURSING AND REHABILITATION, LLC

Doing business as

DELTA SOUTH NURSING & REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 16, 2017

Last certification

Nov 7, 2024

Beds

60

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Enrollment address

640 Colonel George E Day Pkwy
Sikeston, MO 63801-3806

Nursing home name

DELTA SOUTH NURSING & REHABILITATION

Listed as

Delta South Nursing & RehabilitationCCN 265862 · 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 - Limited Liability company

Certified

Aug 16, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6051.9 residents per day on average

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 3

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

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.

• Madhu Sahai, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Sikeston, MO
  • NPI 1972658979
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Madhu Sahai, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Sikeston, MO
  • NPI 1972658979

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1265988950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 FALCON DR",
            "city": "MALDEN",
            "state": "MO",
            "postal_code": "638631017",
            "telephone_number": "573-683-1355",
            "fax_number": "573-475-8693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 COLONEL GEORGE E DAY PARKWAY",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638010624",
            "telephone_number": "573-471-3400",
            "fax_number": "573-471-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA SOUTH SKILLED NURSING AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "BOBBIE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "573-683-1355"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100046542",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Lynn Delaughter, FNP-C
• Kasie Delay, LCSW
• Delta Home Care Inc (Delta-New Hope In-Home Services)
• Delta South Adult Care Center LLC
• Delta South Rehabilitation LLC
• Drew R Dement, PTA
• Laura Nicole Dennis, A.T.C.
• Charlotte C Dewitt, FNP
• Deanna S Dial, APRN
• Margaret L Dicus, FNP

• Skilled Nursing Facility in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.

Verify at the official NPI Registry.