NPIMap

Organization Active NPI

Colonial Acres of Humboldt

Doing business as Colonial Acres Nursing Home

  • Skilled Nursing Facility
  • Humboldt, NE
National Provider Identifier
1285719989
Registry record updated Jun 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
664003 Issued in NE
Legal business name
COLONIAL ACRES OF HUMBOLDT
Doing business as
Colonial Acres Nursing Home
Practice address
1043 10TH St
Humboldt, NE 68376-6018
Phone
(402) 862-3123
Fax
(402) 862-2153
NPI assigned
Oct 25, 2006
Last updated
Jun 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2009

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

Authorized official

Name
Mrs. Brenda Douglas
Title
Board Chairman
Phone
(402) 862-2731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 664003 NE Primary

Addresses

Primary practice location

1043 10TH St
Humboldt, NE 68376-6018

Mailing address

1043 10TH St
Humboldt, NE 68376-6018
Phone (402) 862-3123

Other identifiers 2

IdentifierTypeStateIssuer
10025268600MedicaidNE
60099OtherNEBLUE CROSS BLUE SHIELD

Other names 1

  • Colonial Acres Nursing Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090714000020 NE Part A Provider - Skilled Nursing Facility 1254483894 Practice locations: Humboldt, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285719989. Details of each certification follow.

Skilled nursing facility certification: CCN 285248

Legal name
COLONIAL ACRES OF HUMBOLDT
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2002
Last certification
Oct 3, 2024
Beds
49
Ownership / control type
City
Organization structure
GovernmentNon-profit
Enrollment address
1043 10TH St
Humboldt, NE 68376-6018
Nursing home name
COLONIAL ACRES OF HUMBOLDT
Affiliated entity
RURAL HEALTH DEVELOPMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Colonial Acres of HumboldtCCN 285248 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - City
Certified
Oct 1, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4929.7 residents per day on average
Chain
Rural Health Development9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
28D0454799Colonial Acres Nursing Home1043 10TH Street, Humboldt, NE 68376Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Brenda Douglas Individual Managing Control - Governing Body Nov 1, 2024
Adp of the SNF Nov 1, 2024
Kent J Niss Individual Operational/Managerial Control Apr 1, 2023
Adp of the SNF Apr 1, 2023
Joyce Burnison Individual Managing Control - Governing BodyBoard Chairperson Feb 1, 2022
Adp of the SNF Feb 1, 2022
Elizabeth Packett Individual Operational/Managerial Control Nov 1, 2022
Adp of the SNF Nov 1, 2022
Rex Kappel Individual Managing Control - Governing Body May 1, 2016
Adp of the SNF May 1, 2016
Organization, Grand Island, NE Adp of the SNF Apr 30, 2025
Rural Health Development Inc. Organization, Cambridge, NE Management services company, Consulting firm Operational/Managerial Control Sep 24, 1997
Adp of the SNF May 8, 2025
Debra Lewis Individual Managing Control - Governing Body Jan 1, 2024
Adp of the SNF Jan 1, 2024
Cindy Eden Individual Managing Control - Governing Body Jan 1, 2025
Adp of the SNF Jan 1, 2025
City of Humboldt Organization, Humboldt, NE Adp of the SNF Jul 1, 1969
Direct Ownership Interest Jul 1, 1969 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 9

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

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 8

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1285719989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 10TH ST",
            "city": "HUMBOLDT",
            "state": "NE",
            "postal_code": "683766018",
            "telephone_number": "402-862-3123",
            "fax_number": "402-862-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 10TH ST",
            "city": "HUMBOLDT",
            "state": "NE",
            "postal_code": "683766018",
            "telephone_number": "402-862-3123",
            "fax_number": "402-862-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL ACRES OF HUMBOLDT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "402-862-2731",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NE",
            "license": "664003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025268600",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60099",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Acres Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Humboldt, NE

Sources for this page

Verify at the official NPI Registry.