NPIMap

Organization Active NPI

Columbia Post Acute, LLC

Doing business as Columbia Post Acute

  • Skilled Nursing Facility
  • Columbia, MO
National Provider Identifier
1578088183
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COLUMBIA POST ACUTE, LLC
Doing business as
Columbia Post Acute
Practice address
3535 Berrywood Dr
Columbia, MO 65201-6584
Phone
(573) 397-7144
NPI assigned
Aug 4, 2017
Last updated
Aug 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
John Mitchell
Title
Secretary
Phone
(385) 988-3319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3535 Berrywood Dr
Columbia, MO 65201-6584

Mailing address

262 N University Ave
Farmington, UT 84025-2975

Other names 1

  • Columbia Post Acute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170925000439 MO Part A Provider - Skilled Nursing Facility 0042584443 Practice locations: Columbia, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1578088183. Details of each certification follow.

Skilled nursing facility certification: CCN 265868

Legal name
COLUMBIA POST ACUTE LLC
Doing business as
COLUMBIA POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 7, 2018
Last certification
Nov 15, 2024
Beds
70
Ownership / control type
Limited Liability Corporation
Multi-facility organization
MAINSTREET DEVELOPMENT
Organization structure
LLCProprietary
Incorporated
Apr 1, 2016 in MO
Enrollment address
3535 Berrywood Dr
Columbia, MO 65201-6584
Nursing home name
COLUMBIA POST ACUTE
Affiliated entity
PACS GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Columbia Post AcuteCCN 265868 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 7, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7066.6 residents per day on average
Chain
Pacs Group274 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2138818Columbia Post Acute, LLC3535 Berrywood Drive, Columbia, MO 65201Certificate of waiverOct 24, 2027

National Provider Directory

National Provider Directory

Locations

3535 Berrywood Dr
Columbia, MO 65201
Phone (573) 397-7144

Ownership & related parties

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.

NameRoleSinceShare
Jason H Murray Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
John T Mitchell Individual Corporate OfficerSecretary Jan 1, 2024
David T James Individual Contracted Managing EmployeeMD; Mar 1, 2018
Mainstreeidence Developments LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Direct Ownership Interest Apr 1, 2016 100%
Frederick G Apt Individual Corporate OfficerTreasurer Jan 1, 2024
Christopher McClain Individual W-2 Managing EmployeeAdministrator Jan 18, 2021
Operational/Managerial ControlAdministrator Jan 18, 2021
Providence Group NH, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Pacs Holdings, LLC Organization, Farmington, UT LLC, Holding company 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Joshua O Jergensen Individual Corporate OfficerPresident Jan 1, 2024
Pacs Group, Inc. Organization, Farmington, UT Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 30, 2023 100%
Mark D Hancock Individual 5% Or Greater Indirect Ownership Interest Apr 15, 2024 41.8%
Corporate OfficerCeo Jan 1, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 186

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

View all 186

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1578088183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 BERRYWOOD DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016584",
            "telephone_number": "573-397-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA POST ACUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-04",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "385-988-3319"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.