Marymount Manor LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MARYMOUNT MANOR LLC

Practice address

313 Augustine Rd
Eureka, MO 63025-1935

Phone

(636) 938-6770

Fax

(636) 938-3742

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles J Riley

Title

Memeber

Phone

(636) 349-2311

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Skilled nursing facility certification: CCN 265140

Legal name

MARYMOUNT MANOR LLC

Doing business as

MARYMOUNT MANOR LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 23, 1979

Last certification

Mar 28, 2024

Beds

174

Ownership / control type

Corporation

Multi-facility organization

RILEY SPENCE

Organization structure

LLCProprietary

Enrollment address

313 Augustine Rd
Eureka, MO 63025-1935

Nursing home name

MARYMOUNT MANOR

Affiliated entity

RILEY SPENCE SENIOR LIVING

Listed as

Marymount ManorCCN 265140

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 23, 1979

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

17476.1 residents per day on average

Chain

Riley Spence Senior Living5 facilities in the chain

Penalties (3 years)

1Fines totaling $132,696

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Marymount Manor LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Marymount Manor LLC

  • Assisted Living Facility
  • Eureka, MO
  • NPI 1598828774
  NPD tax ID

All disclosed owners & managing parties 12

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.

• Brittany Elizabeth Herrin, DO

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1124548102

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 4

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

• Rolla Grand LLC

  • Skilled Nursing Facility
  • Rolla, MO
  • NPI 1881249464

  Riley Spence Management Company, LLC

  CMS ownership
• Silverstone SNF LLC

  • Skilled Nursing Facility
  • Rolla, MO
  • NPI 1003224825

  Riley Spence Management Company, LLC

  CMS ownership
• The Woodlands of Maryland Heights LLC

  • Skilled Nursing Facility
  • Maryland Heights, MO
  • NPI 1487715793

  Riley Spence Management Company, LLC

  CMS ownership
• Woodland Manor of Arnold LLC

  • Skilled Nursing Facility
  • Arnold, MO
  • NPI 1245391507

  Riley Spence Management Company, LLC

  CMS ownership

Practitioners 2

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

• Brittany Elizabeth Herrin, DO

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1124548102
  NPD (past)
• Patrick Joseph McCann, MD

  • Internal Medicine Physician
  • St Louis, MO
  • NPI 1437275963
  NPD (past)

Affiliated clinicians 1

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

• Brittany Elizabeth Herrin, DO

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1124548102

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1457412587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 GILSINN LN",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262003",
            "telephone_number": "636-349-2311",
            "fax_number": "636-349-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 AUGUSTINE RD",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251935",
            "telephone_number": "636-938-6770",
            "fax_number": "636-938-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYMOUNT MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMEBER",
        "authorized_official_telephone_number": "636-349-2311",
        "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": "101491009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Ludwig
• Rocky Lupardus, D.M.D.
• Matthew Marian, PHARMD
• Lizabeth Marquart
• Jill Martin, PTA
• Marymount Manor LLC
• Arthur J McAlister, MPT
• Brenda McCarthy, MOT
• Kathleen A McEntee
• Mercer Physical Therapy LLC

• Skilled Nursing Facility in Eureka, MO
• Providers in Eureka, 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 Dec 1, 2009; 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.