Organization Active NPI

N & R of Dexter, Inc.

  • Skilled Nursing Facility
  • Dexter, MO
National Provider Identifier
1639165020
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
030780 Issued in MO
Legal business name
N & R OF DEXTER, INC.
Doing business as
Crowley Ridge Care Center
Practice address
1204 N Outer Rd
Dexter, MO 63841-8684
Phone
(573) 624-5557
Fax
(573) 624-5558
NPI assigned
Sep 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Carla Hedrick, CFO
Title
Cfo
Phone
(573) 481-9625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 030780 MO Primary

Addresses

Primary practice location

1204 N Outer Rd
Dexter, MO 63841-8684

Mailing address

1204 N Outer Rd
Dexter, MO 63841-8684
Phone (573) 624-5557

Other identifiers 2

IdentifierTypeStateIssuer
16878060OtherMOSTATE ID
102334604MedicaidMO

Other names 1

  • Crowley Ridge Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 199.119.81.30:8291 Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000759 MO Part A Provider - Skilled Nursing Facility 8628167756 Practice locations: Dexter, MO

Skilled nursing facility certification: CCN 265552

Legal name
N & R OF DEXTER INC
Doing business as
CROWLEY RIDGE CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 21, 1993
Last certification
Mar 20, 2025
Beds
90
Ownership / control type
Individual
Multi-facility organization
HEALTH SYSTEMS INC
Most recent change of ownership
Jan 1, 1999
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1999 in MO
Enrollment address
1204 N Outer Rd
Dexter, MO 63841-8684
Nursing home name
CROWLEY RIDGE CARE CENTER
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Crowley Ridge Care CenterCCN 265552 · All quality measures
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Oct 21, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9047.5 residents per day on average
Chain
James & Judy Lincoln56 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
26D0673256Crowley Ridge Care Center1204 N Outer Road, Dexter, MO 63841Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Brandon Bysor Individual Corporate DirectorMember Apr 25, 2022 50%
Charlotte a Stutts Individual Corporate OfficerSecretary Jan 1, 1999 50%
Kristi Hensley Individual W-2 Managing EmployeeAdministrator Apr 25, 2022 100%
Timothy O Drake Individual Corporate OfficerPresident Jan 1, 1999 50%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Jan 1, 1999 50%
N & R of Dexter Inc Organization, Dexter, MO 5% Or Greater Direct Ownership Interest Jan 1, 1999
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Jan 1, 1999 50%

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1639165020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N OUTER RD",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638418684",
            "telephone_number": "573-624-5557",
            "fax_number": "573-624-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N OUTER RD",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638418684",
            "telephone_number": "573-624-5557",
            "fax_number": "573-624-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N & R OF DEXTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-481-9625",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE ID",
            "identifier": "16878060",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102334604",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "199.119.81.30:8291",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 w 108th ter",
            "city": "overland park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Crowley Ridge Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dexter, MO

Sources for this page

Verify at the official NPI Registry.