Independence Health System, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

031654 Issued in MO

Legal business name

INDEPENDENCE HEALTH SYSTEM, INC.

Practice address

800 S Kingshighway St
Perryville, MO 63775-2106

Phone

(573) 547-6546

Fax

(573) 547-2823

NPI assigned

Sep 22, 2005

Last updated

Nov 19, 2014By 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

Mrs. Bonnie Schnurbusch

Title

Administrator

Phone

(573) 547-6546

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619963972. Details of each certification follow.

• CCN 265829 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265829

Legal name

INDEPENDENCE HEALTH SYSTEM INC

Doing business as

INDEPENDENCE CARE CENTER OF PERRY COUNTY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 24, 2009

Last certification

Aug 22, 2024

Beds

133

Ownership / control type

Other Nonprofit

Organization structure

CorporationNon-profit

Incorporated

Jan 21, 1969 in MO

Enrollment address

800 S Kingshighway St
Perryville, MO 63775-2106

Nursing home name

INDEPENDENCE CARE CENTER OF PERRY COUNTY

Listed as

Independence Care Center of Perry CountyCCN 265829 · All quality measures

Overall star rating

3 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Apr 24, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

13375.2 residents per day on average

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 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold 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.

• Theodore Rogers, MD

  • Family Medicine Physician
  • Perryville, MO
  • NPI 1699111781
  NPD (past)
• Mark B. Schabbing, M.D.

  • Family Medicine Physician
  • Perryville, MO
  • NPI 1861584534
  NPD (past)

Affiliated clinicians 6

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

• Dominic Jeffrey Haertling, MD

  • Internal Medicine Physician
  • Perryville, MO
  • NPI 1558821413

  Nursing home

  Care Compare affiliation
• David F. Kapp, M.D.

  • Family Medicine Physician
  • Perryille, MO
  • NPI 1871685545

  Nursing home

  Care Compare affiliation
• David E. Melchior, D.O.

  • Family Medicine Physician
  • Perryville, MO
  • NPI 1780776450

  Nursing home

  Care Compare affiliation
• Theodore Rogers, MD

  • Family Medicine Physician
  • Perryville, MO
  • NPI 1699111781

  Nursing home

  Care Compare affiliation
• Mark B. Schabbing, M.D.

  • Family Medicine Physician
  • Perryville, MO
  • NPI 1861584534

  Nursing home

  Care Compare affiliation
• Laurie A. Womack, M.D.

  • Family Medicine Physician
  • Festus, MO
  • NPI 1942392618

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1619963972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S KINGSHIGHWAY ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752106",
            "telephone_number": "573-547-6546",
            "fax_number": "573-547-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S KINGSHIGHWAY ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752106",
            "telephone_number": "573-547-6546",
            "fax_number": "573-547-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "SCHNURBUSCH",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-547-6546",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "031348",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101493203",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268114808",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Huber, DPT
• Jonathan Hudak, LPC, NCC, MA
• Joseph David Hutchison, D.D.S.
• Immediate Convenient Care-Perryville, LLC
• Immediate Healthcare, Inc.
• Katie Marie Isgriggs, BS, HIS
• J.U.S.T. Orthotics
• Joe David Hutchison, D.D.S., P.C.
• John G. Esswein, DDS, LLC
• Kirsten Johnston, PTA

• Skilled Nursing Facility in Perryville, MO
• Providers in Perryville, 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 19, 2014; 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.