St. Peters Manor, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0168041CF Issued in MO

Legal business name

ST. PETERS MANOR, INC.

Doing business as

St Peters Manor Care Center

Practice address

230 Spencer Rd
Saint Peters, MO 63376-2425

Phone

(636) 441-2750

Fax

(636) 447-2835

NPI assigned

Sep 13, 2006

Last updated

Nov 23, 2016By 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

Benjamin C. Scheulen

Title

Ceo

Phone

(573) 556-6240

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• St Peters Manor Care Center Doing business as

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1457456667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 SPENCER ROAD",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-441-2750",
            "fax_number": "636-447-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 SPENCER RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762425",
            "telephone_number": "636-441-2750",
            "fax_number": "636-447-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. PETERS MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "SCHEULEN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "573-556-6240"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "019803SNF",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "0168041CF",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106961105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Peters Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• St. Peters Community Healthcare, LLC (St. Peters Post Acute)
• St. Peters Cosmetic and Family Dentistry LLC
• St. Peters Orthodontics LLC (Unger Orthodontics)
• Laurie Stabile, OTR/L
• Courtney Stallis, OTR/L
• Ethan Stanley, DC
• Joseph Stanley Jr., PHD

• Skilled Nursing Facility in Saint Peters, MO
• Providers in Saint Peters, 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 Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.