Carroll House, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

029457 Issued in MO

Legal business name

CARROLL HOUSE, INC.

Doing business as

Carroll House

Practice address

306 Grand Ave
Carrollton, MO 64633-2203

Phone

(660) 542-1599

Fax

(660) 542-3241

NPI assigned

Sep 21, 2005

Last updated

Sep 15, 2025By 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

Carla Hedrick, CFO

Title

Cfo

Phone

(573) 481-9625

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Carroll House Doing business as

Electronic endpoints 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 1346236791. Details of each certification follow.

• CCN 265706 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265706

Legal name

CARROLL HOUSE, INC.

Doing business as

CARROLL HOUSE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 29, 2000

Last certification

May 30, 2024

Beds

63

Ownership / control type

Corporation

Multi-facility organization

HSI

Organization structure

CorporationProprietary

Incorporated

Jan 1, 2000 in MO

Enrollment address

307 Grand Ave
Carrollton, MO 64633-2265

Nursing home name

CARROLL HOUSE

Affiliated entity

JAMES & JUDY LINCOLN

Listed as

Carroll HouseCCN 265706 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 29, 2000

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6358.6 residents per day on average

Chain

James & Judy Lincoln56 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

1Fines totaling $84,890

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 7

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.

• Richard Lee Smith, M.D.

  • Family Medicine Physician
  • Carrollton, MO
  • NPI 1861448664
  NPD (past)

Affiliated clinicians 2

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

• Buntee Co, MD

  • Psychiatry Physician
  • Fewtus, MO
  • NPI 1437210796

  Nursing home

  Care Compare affiliation
• Makayla Kenike Hampton-Barnett

  • Psychiatric/Mental Health Nurse Practitioner
  • Belleville, IL
  • NPI 1477361343

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1346236791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 GRAND AVE",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "646332203",
            "telephone_number": "660-542-1599",
            "fax_number": "660-542-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 GRAND AVE",
            "city": "CARROLLTON",
            "state": "MO",
            "postal_code": "646332203",
            "telephone_number": "660-542-1599",
            "fax_number": "660-542-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-481-9625",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "029457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "17206936",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106967904",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "199.119.81.30:8291",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 w 108th ter",
            "city": "overland park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Carroll House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carroll County Hospital Phtysicians
• Carroll County Medical Clinic
• Carroll County Memorial Hospital (Carroll County Memorial Hospital Home Health Care Agency)
• Carroll County Memorial Hospital
• Carroll County Memorial Hospital (Reid Medical Clinic)
• Carrollton Chiropractic Clinic, LLC
• Carrollton Dental Clinic
• Carrollton R-VII
• Erin Keeley Magee Casner, PHARM.D.
• Cynthia Lynne Cauble, LCSW

• Skilled Nursing Facility in Carrollton, MO
• Providers in Carrollton, 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 Sep 15, 2025; 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.