Clayton Road Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CLAYTON ROAD HEALTHCARE LLC

Doing business as

Athene Nursing and Rehabilitation

Practice address

13995 Clayton Rd
Town and Country, MO 63017-8400

Phone

(314) 646-7600

NPI assigned

Jun 9, 2023

Last updated

Jun 9, 2023By 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

William Miller

Title

Authorized Person

Phone

(253) 268-2410

Specialties & licenses 1

Addresses

Other names 1

• Athene Nursing and Rehabilitation Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386328433. Details of each certification follow.

• CCN 265001 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265001

Legal name

CLAYTON ROAD HEALTHCARE LLC

Doing business as

ATHENE NURSING AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Nov 1, 1969

Last certification

Feb 15, 2024

Beds

282

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Vertical Health Services

Organization structure

LLCProprietary

Incorporated

May 15, 2023 in DE

Enrollment address

13995 Clayton Rd
Chesterfield, MO 63017-8400

Nursing home name

ATHENE NURSING AND REHABILITATION

Affiliated entity

VERTICAL HEALTH SERVICES

Listed as

Athene Nursing and RehabilitationCCN 265001 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Nov 1, 1969

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

282159.6 residents per day on average

Chain

Vertical Health Services15 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

7Fines totaling $122,846

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

All disclosed owners & managing parties 5

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

Owners & managing parties with NPI records 1

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

• Elizabeth H Maylack, D.O.

  • Family Medicine Physician
  • Saint Charles, MO
  • NPI 1154687077

  Adp of the SNF

  CMS ownership

Practitioners 3

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.

• Elizabeth H Maylack, D.O.

  • Family Medicine Physician
  • Saint Charles, MO
  • NPI 1154687077
  NPD (past)
• Jawed H. Siddiqui, M.D.

  • Internal Medicine Physician
  • Florissant, MO
  • NPI 1699705293
  NPD (past)
• Chantri Trinh, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1023026804
  NPD (past)

Affiliated clinicians 1

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

• Chantri Trinh, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1023026804

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1386328433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11012 CANYON RD E STE 8",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13995 CLAYTON RD",
            "city": "TOWN AND COUNTRY",
            "state": "MO",
            "postal_code": "630178400",
            "telephone_number": "314-646-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON ROAD HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "AUTHORIZED PERSON",
        "authorized_official_telephone_number": "253-268-2410"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athene Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Town and Country, MO
• Providers in Town and Country, 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 Jun 9, 2023; 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.