Edwardsville Operator, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EDWARDSVILLE OPERATOR, LLC

Practice address

751 Blake St
Edwardsville, KS 66111-1338

Phone

(813) 441-1900

NPI assigned

Sep 11, 2019

Last updated

Sep 11, 2019By 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

Stuart Lindeman

Title

President and Ceo

Phone

(813) 280-1333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487203444. Details of each certification follow.

• CCN 175245 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 175245

Legal name

EDWARDSVILLE OPERATOR LLC

Doing business as

EDWARDSVILLE CARE AND REHAB

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1993

Last certification

Aug 21, 2024

Beds

102

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Mission Health Communities

Most recent change of ownership

Oct 1, 2019

Organization structure

LLCProprietary

Incorporated

Jul 23, 2019 in FL

Enrollment address

751 Blake St
Edwardsville, KS 66111-1338

Nursing home name

EDWARDSVILLE CARE AND REHAB

Affiliated entity

MISSION HEALTH COMMUNITIES

Listed as

Edwardsville Care and RehabCCN 175245 · All quality measures

Overall star rating

2 of 5

Health inspections

1 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Apr 1, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10293.0 residents per day on average

Chain

Mission Health Communities30 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

3Fines totaling $38,753

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 11

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 38

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

• Arma Operator LLC

  dba Arma Health and Rehab

  • Skilled Nursing Facility
  • Arma, KS
  • NPI 1144525031

  Barres, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Chase County Operator, LLC

  • Skilled Nursing Facility
  • Cottonwood Falls, KS
  • NPI 1639728686

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Colby Operator, LLC

  dba Colby Health and Rehab

  • Skilled Nursing Facility
  • Colby, KS
  • NPI 1285824797

  Barres, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Downs Operator, LLC

  • Skilled Nursing Facility
  • Downs, KS
  • NPI 1619526662

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• El Dorado Operator, LLC

  • Skilled Nursing Facility
  • El Dorado, KS
  • NPI 1568011526

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Eskridge Operator, LLC

  • Skilled Nursing Facility
  • Eskridge, KS
  • NPI 1083263040

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Hutchinson Operator, LLC

  dba Hutchinson Health and Rehab

  • Skilled Nursing Facility
  • Hutchinson, KS
  • NPI 1700883352

  Barres, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Kaw River Operator, LLC

  • Skilled Nursing Facility
  • Edwardsville, KS
  • NPI 1437708427

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Lansing Operator, LLC

  • Skilled Nursing Facility
  • Lansing, KS
  • NPI 1043869035

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• McPherson Operator, LLC

  dba McPherson Health and Rehab

  • Skilled Nursing Facility
  • McPherson, KS
  • NPI 1770580367

  Barres, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Neodesha Operator, LLC

  • Skilled Nursing Facility
  • Neodesha, KS
  • NPI 1760031751

  Barres, LLC, Coronado Operator, LLC, Curis Holdings, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  CMS ownership
• Onaga Operator, LLC

  dba Onaga Health and Rehab

  • Skilled Nursing Facility
  • Onaga, KS
  • NPI 1619167137

  Barres, LLC, Mission Health Communities, LLC, T and C Capital Assets, LLC, Windward Health Partners LLC

  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.

• Mark Irwin Petersen, MD

  • Internal Medicine Physician
  • Tonganoxie, KS
  • NPI 1881647543
  NPD (past)

Affiliated clinicians 1

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

• Mark Irwin Petersen, MD

  • Internal Medicine Physician
  • Tonganoxie, KS
  • NPI 1881647543

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1487203444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 W BAY TO BAY BLVD STE 303",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336298187",
            "telephone_number": "813-280-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 BLAKE ST",
            "city": "EDWARDSVILLE",
            "state": "KS",
            "postal_code": "661111338",
            "telephone_number": "813-441-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDSVILLE OPERATOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "LINDEMAN",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "813-280-1333"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia R Boal, MSW
• Melody A Chess, OTR
• City of Edwardsville KS
• Michelle Yvonne Cobler, O.T.
• Edwardsville Care and Rehabilitation Center, LLC
• Michelle Ann Eickhoff, NP
• Eps on Site Solutions
• Maria Herrera
• Kaw River Care and Rehabilitation Center, LLC
• Kaw River Operator, LLC

• Skilled Nursing Facility in Edwardsville, KS
• Providers in Edwardsville, KS by specialty
• Skilled Nursing Facility in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.