NPIMap

Organization Active NPI

Eldercare of Mid-Missouri V, Inc.

Doing business as StoneBridge Lake Ozark

  • Skilled Nursing Facility
  • Osage Beach, MO
National Provider Identifier
1326205253
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ELDERCARE OF MID-MISSOURI V, INC.
Doing business as
StoneBridge Lake Ozark
Practice address
872 College Blvd
Osage Beach, MO 65065-8408
Phone
(573) 302-0900
NPI assigned
May 19, 2008
Last updated
Dec 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Mr. Mark Lierman
Title
Secretary-Treasurer
Phone
(636) 477-3280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

872 College Blvd
Osage Beach, MO 65065-8408

Mailing address

2500 S Old Highway 94
Suite 104
Saint Charles, MO 63303-5616
Phone (636) 477-3280

Other identifiers 1

IdentifierTypeStateIssuer
108303207MedicaidMO

Other names 1

  • StoneBridge Lake Ozark Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000458 MO Part A Provider - Skilled Nursing Facility 8628143542 Practice locations: Osage Beach, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326205253. Details of each certification follow.

Skilled nursing facility certification: CCN 265779

Legal name
ELDERCARE OF MID-MISSOURI V, INC.
Doing business as
STONEBRIDGE LAKE OZARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 30, 2004
Last certification
Aug 2, 2024
Beds
66
Ownership / control type
Individual
Multi-facility organization
STONEBRIDGE SENIOR LIVING
Organization structure
CorporationProprietary
Enrollment address
872 College Blvd
Osage Beach, MO 65065-8408
Nursing home name
STONEBRIDGE LAKE OZARK
Affiliated entity
STONEBRIDGE SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Stonebridge Lake OzarkCCN 265779 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 30, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6654.1 residents per day on average
Chain
Stonebridge Senior Living12 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Beth Miller Individual Corporate OfficerSecretary Jan 17, 2023
Eric Doerhoff Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Eldercare Management Services Inc Organization, Saint Charles, MO Corporation, Management services company, Chain home office Operational/Managerial Control Mar 12, 2008
Adp of the SNF Apr 22, 2025
Jeanne Thayer Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Christine a Livek Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Lierman Family Co V, LLC Organization, Saint Charles, MO LLC Adp of the SNF Mar 12, 2008
Wipfli LLP Organization, Clayton, MO Adp of the SNF Jan 1, 2025
Linda B Hagler-Reid Individual Operational/Managerial Control Dec 24, 2023
Adp of the SNF Dec 24, 2023
Bridge Rehabilitation Inc Organization, Saint Charles, MO Corporation, Medical provider/supplier Operational/Managerial Control Feb 1, 2024
Adp of the SNF Apr 22, 2025
Kara Knight Individual Operational/Managerial Control Mar 1, 2018
Adp of the SNF Mar 1, 2018
Mark W Lierman Individual 5% Or Greater Direct Ownership InterestPresident Nov 1, 2021 100%
Corporate OfficerPresident Nov 1, 2021 100%
Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Adp of the SNF Jan 25, 2016
Busey Corporation Organization, Clayton, MO Financial institution Operational/Managerial Control Sep 10, 2023
Steven Ciegel Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
John McBryant Individual Operational/Managerial Control Mar 4, 2022
Adp of the SNF Mar 4, 2022

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 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1326205253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S OLD HIGHWAY 94",
            "address_2": "SUITE 104",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633035616",
            "telephone_number": "636-477-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 COLLEGE BLVD",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650658408",
            "telephone_number": "573-302-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE OF MID-MISSOURI V, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "LIERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SECRETARY-TREASURER",
        "authorized_official_telephone_number": "636-477-3280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108303207",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StoneBridge Lake Ozark",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.