NPIMap

Organization Active NPI

Putnam County Nursing Home

  • Skilled Nursing Facility
  • Unionville, MO
National Provider Identifier
1629035100
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
030653 Issued in MO
Legal business name
PUTNAM COUNTY NURSING HOME
Practice address
1814 Oak St
Unionville, MO 63565-1275
Phone
(660) 947-2492
NPI assigned
Apr 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Authorized official

Name
Passion Wyant
Title
Administrator
Phone
(660) 947-2492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 030653 MO Primary

Addresses

Primary practice location

1814 Oak St
Unionville, MO 63565-1275

Mailing address

1814 Oak St
Unionville, MO 63565-1275
Phone (660) 947-2492

Other identifiers 1

IdentifierTypeStateIssuer
10149380MedicaidMO

Other names 1

  • PUTNAM COUNTY CARE CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061215000160 MO Part A Provider - Skilled Nursing Facility 0648279869 Practice locations: Unionville, MO

Skilled nursing facility certification: CCN 265826

Legal name
PUTNAM COUNTY NURSING HOME
Doing business as
PUTNAM COUNTY CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 2009
Last certification
Sep 12, 2024
Beds
60
Ownership / control type
County
Organization structure
OtherNon-profit
Incorporated
in MO
Enrollment address
1814 Oak St
Unionville, MO 63565-1275
Nursing home name
PUTNAM COUNTY CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Putnam County Care CenterCCN 265826
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
Apr 1, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6056.4 residents per day on average
Penalties (3 years)
3Fines totaling $72,664

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Putnam County Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Justin Simmons Individual Corporate Director Apr 15, 2019
David Crossgrove Individual Corporate Director Apr 1, 2004
Passion R Wyant Individual Corporate DirectorAdministrator Jun 17, 2008
W-2 Managing Employee Jun 17, 2008
Jane Rexroat Individual Corporate Director Sep 29, 2014
Richard Morrow Individual Corporate DirectorBoard Member Treasurer Jul 17, 2014
Janet Kerby Individual Corporate DirectorBoard Member Apr 8, 2014
Cassadrea L Harlan Individual W-2 Managing EmployeeBusiness Office Sep 29, 2014
Sherry Munden Individual Corporate Director Apr 16, 2018

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1629035100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 OAK ST",
            "city": "UNIONVILLE",
            "state": "MO",
            "postal_code": "635651275",
            "telephone_number": "660-947-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 OAK ST",
            "city": "UNIONVILLE",
            "state": "MO",
            "postal_code": "635651275",
            "telephone_number": "660-947-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUTNAM COUNTY NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "WYANT",
        "authorized_official_first_name": "PASSION",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "660-947-2492"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10149380",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PUTNAM COUNTY CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Unionville, MO

Sources for this page

Verify at the official NPI Registry.