Ellington 1 Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

045515 Issued in MO

Legal business name

ELLINGTON 1 INC

Doing business as

Brent B Tinnin Manor

Practice address

220 Euel Polk Dr
Ellington, MO 63638-7967

Phone

(573) 663-2545

NPI assigned

Jul 7, 2006

Last updated

Aug 30, 2017By 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

Donald B Bedell

Title

President

Phone

(573) 471-1276

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brent B Tinnin Manor 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 1629000690. Details of each certification follow.

• CCN 265472 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265472

Legal name

ELLINGTON 1 INC

Doing business as

BRENT B TINNIN MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 21, 1991

Last certification

Mar 19, 2025

Beds

60

Ownership / control type

Individual

Organization structure

CorporationProprietary

Enrollment address

220 Euel Polk Dr
Ellington, MO 63638-7967

Nursing home name

BRENT B TINNIN MANOR

Affiliated entity

CIRCLE B ENTERPRISES

Listed as

Brent B Tinnin ManorCCN 265472 · All quality measures

Overall star rating

1 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Oct 21, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6040.7 residents per day on average

Chain

Circle B Enterprises36 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 2

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

• Rodney T. Rubi, MD

  • Internal Medicine Physician
  • Ellington, MO
  • NPI 1184727422

  Adp of the SNF, Operational/Managerial Control

  CMS ownership
• Sovereign Healthcare Group, LLC

  • Home Health Agency
  • New Madrid, MO
  • NPI 1447821418

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 41

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

• Ava No 1 Inc

  • Skilled Nursing Facility
  • Ava, MO
  • NPI 1518999515

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Boonville No 1 Inc

  dba Lakeview Health Care & Rehabilitation Center

  • Skilled Nursing Facility
  • Boonville, MO
  • NPI 1295767275

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Boonville No2 Inc

  dba Riverdell Care Center

  • Skilled Nursing Facility
  • Boonville, MO
  • NPI 1740212760

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Cameron No 1 Inc

  dba Quail Run Health Care Center

  • Skilled Nursing Facility
  • Cameron, MO
  • NPI 1194757112

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Cape Girardeau I Inc

  dba Heartland Care & Rehabilitation Center

  • Skilled Nursing Facility
  • Cape Girardeau, MO
  • NPI 1649202623

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Caruthersville No 1 Inc

  dba Southgate Living Center

  • Skilled Nursing Facility
  • Caruthersville, MO
  • NPI 1457708018

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Clinton No 1 Inc

  • Skilled Nursing Facility
  • Clinton, MO
  • NPI 1033141015

  Agh1 LLC, Sovereign Healthcare Group LLC

  CMS ownership
• Clinton No 2 Inc

  dba Adair Village

  • Skilled Nursing Facility
  • Clinton, MO
  • NPI 1548913288

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Collins Acres Care Center Inc

  dba Sikeston Convalescent Center

  • Skilled Nursing Facility
  • Sikeston, MO
  • NPI 1912939976

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Delhaven Manor No 2 Inc

  dba Delhaven Manor

  • Skilled Nursing Facility
  • Saint Louis, MO
  • NPI 1750313730

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Excelsior Spring 1 Inc

  dba Valley Manor & Rehabilitation Center

  • Skilled Nursing Facility
  • Excelsior Springs, MO
  • NPI 1265464234

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  CMS ownership
• Granby No 1 Inc

  dba Granby House

  • Skilled Nursing Facility
  • Granby, MO
  • NPI 1073545067

  Agh1 LLC, Circle B Enterprises Holding Company Inc, Sovereign Healthcare Group LLC

  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.

• Abdullah Arshad, MD

  • Internal Medicine Physician
  • Hayti, MO
  • NPI 1477660637
  NPD (past)
• Rodney T. Rubi, MD

  • Internal Medicine Physician
  • Ellington, MO
  • NPI 1184727422
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1629000690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 EUEL POLK DR",
            "city": "ELLINGTON",
            "state": "MO",
            "postal_code": "636387967",
            "telephone_number": "573-663-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLINGTON 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "BEDELL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "045515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101776201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brent B Tinnin Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bradley R Daniel, DMD
• Brooklynn Renee Dement
• Natalie Donnell
• Dr. Stephen C. Waller, DDS, LLC
• Megan S Drake
• Stella Diane Fernandes
• Deeanna Lynn Freeman, RN
• Scott Lee Fulkerson
• John R Galloway, DDS
• Bhaskar Gupta, DDS

• Skilled Nursing Facility in Ellington, MO
• Providers in Ellington, 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 Aug 30, 2017; 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.