Premier Estates of Kenesaw, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PREMIER ESTATES OF KENESAW, LLC

Practice address

100 W Elm St
Kenesaw, NE 68956-1543

Phone

(402) 752-3212

Fax

(402) 752-8128

NPI assigned

Apr 30, 2015

Last updated

Oct 14, 2015By 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

Gregory Bench

Title

Cfo

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407233257. Details of each certification follow.

• CCN 285166 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 285166

Legal name

PREMIER ESTATES OF KENESAW, LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 17, 1995

Last certification

Aug 1, 2024

Beds

76

Ownership / control type

Corporation

Multi-facility organization

Accura Healthcare

Organization structure

LLCProprietary

Incorporated

Feb 18, 2015 in FL

Enrollment address

100 W Elm St
Kenesaw, NE 68956-1543

Listed as

Accura HealthCare of KenesawCCN 285166 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 17, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7664.8 residents per day on average

Penalties (3 years)

5Fines totaling $71,975

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 8

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

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Premier Estates of Pierce, LLC

  • Skilled Nursing Facility
  • Pierce, NE
  • NPI 1205213055

  Arboreta Health and Rehabilitation Centers, LLC, Arboreta Healthcare Consulting, LLC, Iane Properties I LLC

  CMS ownership
• Premier Estates 502, LLC

  dba Grandview Health Care Center

  • Skilled Nursing Facility
  • Dayton, IA
  • NPI 1972969681

  Arboreta Health and Rehabilitation Centers, LLC, Arboreta Healthcare Consulting, LLC, Arboreta Healthcare, Inc

  CMS ownership
• Premier Estates 507, LLC

  dba Lenox Care Center

  • Skilled Nursing Facility
  • Lenox, IA
  • NPI 1265898969

  Arboreta Health and Rehabilitation Centers, LLC, Arboreta Healthcare Consulting, LLC, Arboreta Healthcare, Inc

  CMS 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.

• Douglas J Althouse, MD

  • Family Medicine Physician
  • Minden, NE
  • NPI 1447283601
  NPD (past)

Affiliated clinicians 2

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

• Douglas J Althouse, MD

  • Family Medicine Physician
  • Minden, NE
  • NPI 1447283601

  Nursing home

  Care Compare affiliation
• Grant E Nitzel, M.D.

  • Family Medicine Physician
  • Hastings, NE
  • NPI 1104821149

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1407233257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 OFFICE PARK BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033441",
            "telephone_number": "941-758-4745",
            "fax_number": "941-751-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W ELM ST",
            "city": "KENESAW",
            "state": "NE",
            "postal_code": "689561543",
            "telephone_number": "402-752-3212",
            "fax_number": "402-752-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES OF KENESAW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100265079-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Devin A Gamble
• Lila Jane Gamble, SLP
• Guardian Angel Life Services, Inc
• Kenesaw Public Schools
• Brian Scott Ortgies
• Matthew Brian Reiman
• SSC Kenesaw Operating Company LLC (Haven Home)
• Mark Dale Stubblefield
• Roberta Irene Stubblefield
• The Mary Lanning Memorial Hospital Association (Mary Lanning Hospice)

• Skilled Nursing Facility in Kenesaw, NE
• Providers in Kenesaw, NE by specialty
• Skilled Nursing Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.