NPIMap

Organization Active NPI

Malik St Louis LLC

  • Skilled Nursing Facility
  • Saint Louis, MO
National Provider Identifier
1295467306
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MALIK ST LOUIS LLC
Practice address
5408 S Broadway
St Louis, MO 63111-2023
Phone
(314) 353-7225
NPI assigned
Jun 28, 2022
Last updated
Jun 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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 NU Primary

Addresses

Primary practice location

5408 S Broadway
St Louis, MO 63111-2023

Mailing address

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250707002383 MO Part A Provider - Skilled Nursing Facility 9234643909 Practice locations: Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295467306. Details of each certification follow.

Skilled nursing facility certification: CCN 265892

Legal name
MALIK ST LOUIS LLC
Doing business as
ST LOUIS ALTENHEIM
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 26, 2026
Last certification
Sep 12, 2024
Beds
73
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
5408 S Broadway
Saint Louis, MO 63111-2023
Nursing home name
ST LOUIS ALTENHEIM
Affiliated entity
SHAFIQ MALIK

Care Compare: Nursing home

Medicare Care Compare
Listed as
St Louis AltenheimCCN 265892 · All quality measures
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 26, 2026
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
73
Chain
Shafiq Malik9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Malik St Louis 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.

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 Operational/Managerial Control Jul 1, 2025
Managing Control - Governing BodyOwner Jul 1, 2025
Adp of the SNF Jul 1, 2025
Direct Ownership Interest Jul 1, 2025 50%
Ayaaz Habibullah Individual Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 7, 2025
Jean Bardwell Individual Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 1, 2025
Forvis Mazars LLP Organization, Springfield, MO Consulting firm, For-profit Operational/Managerial Control Aug 30, 2024
Adp of the SNF Jul 1, 2025
Shafiq Malik Individual Operational/Managerial Control Jul 1, 2025
Managing Control - Governing BodyOwner Jul 1, 2025
Adp of the SNF Jul 1, 2025
Direct Ownership Interest Jul 1, 2025 50%
Malik St Louis LLC Organization, Cape Girardeau, MO LLC, For-profit Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 1, 2025
Direct Ownership Interest Jul 1, 2025 100%

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 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.

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": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1295467306",
    "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": "5408 S BROADWAY",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631112023",
            "telephone_number": "314-353-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIK ST LOUIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.