Knox County Nursing Home District

Key facts

NPI: 1316937642
Entity type: Organization (NPI type 2)
Primary specialty: Skilled Nursing Facility 314000000X
License: 031485 (MO)
Legal business name: KNOX COUNTY NURSING HOME DISTRICT
Practice address: 55774 State Highway 6
Edina, MO 63537-4253
Phone: (660) 397-2282
Fax: (660) 397-2284
NPI assigned: Oct 27, 2005
Organization subpart: No

Authorized official

Name: Tim Schrage
Title: Administrator
Phone: (660) 397-2282

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Knox County Nursing Home District Assisted Living Facility · Edina, MO · NPI 1215928130

NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Jeffrey D Davis, DO Family Medicine Physician · Memphis, MO · NPI 1679558589

NPD (past)

Affiliated clinicians 2

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

Jeffrey D Davis, DO Family Medicine Physician · Memphis, MO · NPI 1679558589

Care Compare affiliation Nursing home
Tabitha Sarah Rohr, NP-C Family Nurse Practitioner · Edina, MO · NPI 1447790423

Care Compare affiliation Nursing home

Medicare Care Compare: Nursing home

Listed as: Knox County Nursing Home District CCN 265763
Overall star rating: ★☆☆☆☆ 1 of 5
Health inspections: ★☆☆☆☆ 1 of 5
Staffing: ★★★☆☆ 3 of 5
Quality measures: ★☆☆☆☆ 1 of 5
Type: Medicare and Medicaid
Ownership: Government - County
Certified: Jun 20, 2003
Medicare certification status: Active (Provider of Services file)
Certified beds: 60 · 38.3 residents per day on average
Penalties (3 years): 3 · fines totaling $93,280

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
26D0886722	Knox County Nursing Home District 55774 State Highway 6, Edina, MO 63537	Certificate of waiver	Nov 21, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MO

Skilled nursing facility certification: CCN 265763

Legal name: KNOX COUNTY NURSING HOME DISTRICT
Doing business as: KNOX COUNTY NURSING HOME DISTRICT
Certification status: Active
Provider type (POS): Nursing home – SNF/NF dual certification
Participating since: Jun 20, 2003
Last certification: Feb 1, 2024
Beds: 60
Ownership / control type: County
Organization structure: Government · Non-profit
Enrollment address: 55774 State Highway 6
Edina, MO 63537-4253
Nursing home name: KNOX COUNTY NURSING HOME DISTRICT

All disclosed owners & managing parties 9

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
Brenda Sayres Individual	Managing Control - Governing Body Vice President	Oct 27, 2022
Linda Palmer Individual	Managing Control - Governing Body Board Member	Oct 27, 2022
Ken Berry Individual	Managing Control - Governing Body Corporate Officer	Mar 24, 2021
Knox County Nursing Home District Organization · Edina, MO	5% Or Greater Direct Ownership Interest	May 9, 1967	100%
	5% Or Greater Mortgage Interest	May 9, 1967	100%
	5% Or Greater Security Interest	May 9, 1967	100%
	Operational/Managerial Control	May 9, 1967
Katlind Murry Individual	Operational/Managerial Control	Jul 7, 2022
Lori Strange Individual	Operational/Managerial Control	Jan 6, 2025
Tom Hamlin Individual	Managing Control - Governing Body Board Member	Apr 7, 2022
Pamela Sue Witherow Individual	Managing Control - Governing Body President	Apr 6, 2021
Connie Early Individual	Managing Control - Governing Body Corporate Officer	Nov 15, 2024

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040714001521	MO	Part a Provider - Skilled Nursing Facility	2264411131	Practice locations: Edina, MO

National Provider Directory

Tax ID family: Knox County Nursing Home District (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Skilled Nursing Facility	314000000X	031485	MO	Yes

Addresses

Primary practice location

55774 State Highway 6
Edina, MO 63537-4253

Mailing address

55774 State Highway 6
Edina, MO 63537-4253
Phone (660) 397-2282

Other identifiers

Identifier	Type	State	Issuer
101488906	Medicaid	MO

Other providers in Edina, MO

All providers in Edina, MO · Skilled Nursing Facility in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
Provider of Services files (CMS): certification status, beds and related CCNs.
Medicare Care Compare provider data (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.