Nodaway Healthcare LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

NODAWAY HEALTHCARE LLC

Doing business as

Nodaway Nursing Home

Practice address

22371 State Highway 46
Maryville, MO 64468-8157

Phone

(660) 562-2876

NPI assigned

Feb 20, 2023

Last updated

May 19, 2023By 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

Jennifer Renee Zucca

Title

Dosp

Phone

(816) 564-6978

Specialties & licenses 2

Addresses

Other names 1

• NODAWAY NURSING HOME Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497453344. Details of each certification follow.

• CCN 265836 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265836

Legal name

NODAWAY HEALTHCARE LLC

Doing business as

NODAWAY HEALTHCARE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 2010

Last certification

Oct 10, 2024

Beds

60

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Prime

Organization structure

LLCProprietary

Incorporated

Jul 12, 2022 in MO

Enrollment address

22371 State Highway 46
Maryville, MO 64468-8157

Nursing home name

NODAWAY HEALTHCARE

Affiliated entity

BLUE SKY BASIN, LLC

Listed as

Nodaway HealthcareCCN 265836 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 1, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6032.6 residents per day on average

Chain

Blue Sky Basin, LLC5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 9

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 7

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

• Buffalo Prairie Nursing and Rehab LLC

  dba Buffalo Prairie Center for Rehab and Healthcare

  • Skilled Nursing Facility
  • Buffalo, MO
  • NPI 1013679596

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Country Aire Healthcare LLC

  dba Country Aire Retirement Center

  • Skilled Nursing Facility
  • Lewistown, MO
  • NPI 1619639192

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Georgian Gardens Healthcare LLC

  dba Georgian Gardens Center for Rehab and Healthcare

  • Skilled Nursing Facility
  • Potosi, MO
  • NPI 1972265452

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Golden Years Nursing and Rehab LLC

  dba Golden Years Center for Rehab and Healthcare

  • Skilled Nursing Facility
  • Harrisonville, MO
  • NPI 1063174548

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Sloans Lake Trust

  CMS ownership
• Independence Healthcare LLC

  dba Abode Health and Wellness Center

  • Skilled Nursing Facility
  • Independence, MO
  • NPI 1790658086

  Blue Sky Basin LLC

  CMS ownership
• Oregon Healthcare LLC

  dba Oregon Care Center

  • Nursing Facility/Intermediate Care Facility
  • Oregon, MO
  • NPI 1043918998

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Gateway Mo2 LLC, Sloans Lake Trust

  CMS ownership
• Pleasant View Healthcare LLC

  dba Pleasant View

  • Nursing Facility/Intermediate Care Facility
  • Rock Port, MO
  • NPI 1699473546

  Blue Sky Basin LLC, DKDP Missouri LLC, Dkyh Missouri LLC, Gateway Mo2 LLC, Sloans Lake Trust

  CMS ownership

Practitioners 2

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.

• Sally A. Bomar, M.D.

  • Family Medicine Physician
  • Maryville, MO
  • NPI 1043212228
  NPD (past)
• Amrit P. Singh, M.D.

  • Internal Medicine Physician
  • Maryville, MO
  • NPI 1275589426
  NPD (past)

Affiliated clinicians 2

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

• Sally A. Bomar, M.D.

  • Family Medicine Physician
  • Maryville, MO
  • NPI 1043212228

  Nursing home

  Care Compare affiliation
• Amrit P. Singh, M.D.

  • Internal Medicine Physician
  • Maryville, MO
  • NPI 1275589426

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1497453344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 E 43RD ST S STE 201",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640555911",
            "telephone_number": "816-564-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22371 STATE HIGHWAY 46",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644688157",
            "telephone_number": "660-562-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NODAWAY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "ZUCCA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "DOSP",
        "authorized_official_telephone_number": "816-564-6978"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NODAWAY NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NODAWAY NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nathan Eugene Noakes, LCSW
• Nodaway County Ambulance District
• Nodaway County Health Center
• Nodaway County Services for the Developmentally Disabled, Inc.
• Nodaway County Services for the Developmentally Disabled, Inc.
• Nodaway Physician Services, LLC
• Northwest Chiropractic Clinic
• Northwest Chiropractic Clinic, LLC
• Northwest Health Services, Inc (Maryville High School Health Center)
• Northwest Health Services, Inc. (Maryville Middle School Health Center)

• Nursing Facility/Intermediate Care Facility in Maryville, MO
• Providers in Maryville, MO by specialty
• Nursing Facility/Intermediate Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.