Active NPI
N & R of Camdenton, Inc.
- Skilled Nursing Facility
- Camdenton, MO
National Provider Identifier
1477549822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 031410
- Legal business name
- N & R OF CAMDENTON, INC.
- Practice address
- 2042 N Business Route 5
Camdenton, MO 65020-2611 - Phone
- (573) 346-5654
- Fax
- (573) 346-7472
- NPI assigned
- Sep 21, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carla Hedrick
- Title
- Cfo
- Phone
- (573) 481-9625
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 031410 | MO | Primary |
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
2042 N Business Route 5
Camdenton, MO 65020-2611
Mailing address
2042 N Business Route 5
Camdenton, MO 65020-2611
Phone (573) 346-5654
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101481406 | Medicaid | MO | |
| 17171989 | Other | MO | STATE ID |
Other names 1
- Camdenton Windsor Estates
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070828000926 | MO | Part A Provider - Skilled Nursing Facility | 3678665114 | Practice locations: Camdenton, MO |
Skilled nursing facility certification: CCN 265091
- Legal name
- N & R OF CAMDENTON, INC
- Doing business as
- CAMDENTON WINDSOR ESTATES
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 19, 1970
- Last certification
- Apr 10, 2025
- Beds
- 82
- Ownership / control type
- Corporation
- Multi-facility organization
- HEALTH SYSTEMS INC
- Organization structure
- Corporation
- Incorporated
- Nov 1, 1999 in MO
- Enrollment address
- 2042 N Business Route 5
Camdenton, MO 65020-2611 - Nursing home name
- CAMDENTON WINDSOR ESTATES
- Affiliated entity
- JAMES & JUDY LINCOLN
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Camdenton Windsor Estates
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 19, 1970
- Medicare certification status
- Active
- Certified beds
- 82
- Chain
- James & Judy Lincoln
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0445823 | Camdenton Windsor Estates | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Charlotte a Stutts | Corporate Officer | Nov 1, 1999 | 50% |
| Timothy O Drake | Corporate Director | Nov 1, 1999 | 50% |
| James C Lincoln | 5% Or Greater Direct Ownership Interest | Nov 1, 1999 | 50% |
| Corporate Director | Nov 1, 1999 | ||
| Theresa Knight | W-2 Managing Employee | Sep 23, 2002 | 100% |
| Judy L Lincoln | 5% Or Greater Direct Ownership Interest | Nov 1, 1999 | 50% |
| Corporate Director | Nov 1, 1999 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Eldon, MO
- NPI 1194758011
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1754956800000",
"number": "1477549822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2042 N BUSINESS ROUTE 5",
"city": "CAMDENTON",
"state": "MO",
"postal_code": "650202611",
"telephone_number": "573-346-5654",
"fax_number": "573-346-7472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2042 N BUSINESS ROUTE 5",
"city": "CAMDENTON",
"state": "MO",
"postal_code": "650202611",
"telephone_number": "573-346-5654",
"fax_number": "573-346-7472"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "N & R OF CAMDENTON, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-21",
"last_updated": "2025-08-12",
"certification_date": "2025-08-12",
"status": "A",
"authorized_official_last_name": "HEDRICK",
"authorized_official_first_name": "CARLA",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "573-481-9625"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MO",
"license": "031410",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101481406",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE ID",
"identifier": "17171989",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.1066.1",
"affiliationName": "eSolutions Inc",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CSV",
"address_1": "8215 W 108th Ter",
"city": "Overland Park",
"state": "KS",
"country_code": "US",
"postal_code": "662101661",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Camdenton Windsor Estates",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Camdenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.