NPIMap

Organization Active NPI

Citizens Memorial Health Care Foundation

  • Skilled Nursing Facility
  • Ash Grove, MO
National Provider Identifier
1386624906
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
030495 Issued in MO
Legal business name
CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Practice address
401 N Medical Dr
Ash Grove, MO 65604-1004
Phone
(417) 751-2575
Fax
(417) 751-2833
NPI assigned
Jan 19, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Renee Marie Meyer
Title
Director of Finance
Phone
(417) 328-6258

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 13

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

View all 13

Practitioners 2

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

Affiliated clinicians 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Ash Grove Healthcare FacilityCCN 265571
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 24, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8273.0 residents per day on average
Chain
Citizens Memorial Health Care6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0447054Ash Grove Healthcare Facility401 North Medical Drive, Ash Grove, MO 65604Certificate of waiverAug 31, 2026

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111202000606 MO Part a Provider - Skilled Nursing Facility 1658413455 Practice locations: Ash Grove, MO

Skilled nursing facility certification: CCN 265571

Medicare enrollment files
Legal name
CITIZENS MEMORIAL HEALTH CARE FOUNDATION
Doing business as
ASH GROVE HEALTHCARE FACILITY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 24, 1994
Last certification
Jan 24, 2025
Beds
82
Ownership / control type
Nonprofit Corporation
Multi-facility organization
CITIZENS MEMORIAL HEALTHCAREFOUNDATION
Organization structure
OtherNon-profit
Incorporated
Sep 24, 1986 in MO
Enrollment address
401 N Medical Dr
Ash Grove, MO 65604-1004
Nursing home name
ASH GROVE HEALTHCARE FACILITY
Affiliated entity
CITIZENS MEMORIAL HEALTH CARE

All disclosed owners & managing parties 13

Medicare enrollment files

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

NameRoleSinceShare
Heather Finnell Individual W-2 Managing EmployeeDirector of Finance Jan 1, 2022
Michael Calhoun Individual Corporate OfficerExecutive Director Jan 1, 2022
W-2 Managing EmployeeCeo Jan 1, 2022
Brad Johnson Individual Corporate DirectorBoard Member Jan 1, 2022
William S Donnell Individual Corporate DirectorBoard Member Mar 14, 2012
John Kallenbach Individual Corporate OfficerVice President Jan 1, 2022
Corporate DirectorBoard Member Jun 20, 2019
Christopher McBratney Individual W-2 Managing EmployeeAdministrative Director Sep 6, 2011
Janieca Lynn Hancock Individual Corporate OfficerPresident Jan 1, 2022
Corporate Director Mar 15, 2018
Beverly Derrickson Individual Corporate OfficerChief Operating Officer Jan 27, 2020
Corporate Director Nov 21, 2016
W-2 Managing EmployeeChief Operations Officer Nov 21, 2016
Catherine S Molder Individual Corporate OfficerSecretary of the Board Mar 1, 2002
James Ashworth Individual Corporate DirectorBoard Member Jun 17, 2021
Renee M Meyer Individual Corporate OfficerTreasurer Jan 1, 2022
W-2 Managing EmployeeChief Financial Officer Jul 1, 1997
Donald J Babb Individual Corporate DirectorBoard Member Dec 19, 2019
Dana M Meents Individual Corporate DirectorBoard Member Oct 14, 2010

National Provider Directory

National Provider Directory
Tax ID family
Citizens Memorial Healthcare Foundation Homemaker Plus (14 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 030495 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

401 N Medical Dr
Ash Grove, MO 65604-1004

Mailing address

1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone (417) 326-3000

Other names 1

NPPES NPI Registry
  • Ash Grove Healthcare Facility Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386624906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-3000",
            "fax_number": "417-328-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N MEDICAL DR",
            "city": "ASH GROVE",
            "state": "MO",
            "postal_code": "656041004",
            "telephone_number": "417-751-2575",
            "fax_number": "417-751-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITIZENS MEMORIAL HEALTH CARE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "417-328-6258",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ash Grove Healthcare Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ash Grove, MO

Sources for this page

Verify at the official NPI Registry.