NPIMap

Organization Active NPI

Cape Retirement Community, Inc.

Doing business as Chateau Girardeau

  • Skilled Nursing Facility
  • Cape Girardeau, MO
National Provider Identifier
1659334167
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
031705 Issued in MO
Legal business name
CAPE RETIREMENT COMMUNITY, INC.
Doing business as
Chateau Girardeau
Practice address
3120 Independence St
Cape Girardeau, MO 63703-5043
Phone
(573) 335-1281
Fax
(573) 651-8184
NPI assigned
Apr 7, 2006
Last updated
Feb 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Keith Boeller
Title
President/Ceo
Phone
(573) 651-8186

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 031333 MO
Skilled Nursing Facility 314000000X 031705 MO Primary

Addresses

Primary practice location

3120 Independence St
Cape Girardeau, MO 63703-5043

Mailing address

3120 Independence St
Cape Girardeau, MO 63703-5043
Phone (573) 335-1281

Other identifiers 1

IdentifierTypeStateIssuer
107809105MedicaidMO

Other names 1

  • Chateau Girardeau Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100115000516 MO Part A Provider - Skilled Nursing Facility 6103968078 Practice locations: Cape Girardeau, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659334167. Details of each certification follow.

Skilled nursing facility certification: CCN 265142

Legal name
CAPE RETIREMENT COMMUNITY, INC.
Doing business as
CHATEAU GIRARDEAU
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 23, 1982
Last certification
Jan 23, 2025
Beds
75
Ownership / control type
Other Nonprofit
Organization structure
OtherNon-profit
Incorporated
Dec 9, 1974 in MO
Enrollment address
3120 Independence St
Cape Girardeau, MO 63703-5043
Nursing home name
CHATEAU GIRARDEAU

Care Compare: Nursing home

Medicare Care Compare
Listed as
Chateau GirardeauCCN 265142 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Jul 23, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7553.8 residents per day on average

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
26D0906529Chateau Girardeau3120 Independence Street, Cape Girardeau, MO 63703Certificate of waiverOct 1, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jeannette Fadler Individual Corporate OfficerVice Chair/Chair Elect Jan 1, 2022
Chris Edmonds Individual Corporate OfficerTreasurer Jan 1, 2022
Kevin Schade Individual Corporate OfficerSecretary Jan 1, 2022
Paul Carins Individual Corporate Director Jan 1, 2017
Debra Eudy Individual Corporate DirectorBoard Member Jan 1, 2015
Vernon Kasten Individual Corporate OfficerImmediate Past Chair Jan 27, 2015
Steve Taylor Individual Corporate Director Jan 1, 2019
Charlie Herbst Individual Corporate OfficerChairman Jan 1, 2022
Nancy Mattingly Individual Corporate Director Jan 1, 2019
Teresa Compton Individual Other Jan 3, 2022
Roger Tanner Individual Corporate Director Jan 1, 2021
Chris Sides Individual Corporate Director Jan 1, 2020
Cape Retirement Community, Inc. Organization, Cape Girardeau, MO Non-profit 5% Or Greater Direct Ownership Interest Nov 20, 2009 100%
Operational/Managerial Control Nov 20, 2009
Dean Reeves Individual Corporate Director Jan 1, 2021
John Klein Individual Corporate Director Jan 1, 2021
Mark H Kinder Individual Corporate DirectorBoard Member Feb 22, 2016
Keith Boeller Individual Contracted Managing Employee Jan 1, 2015
Corporate Officer Jan 1, 2015
Corporate DirectorCeo Jan 1, 2015
W-2 Managing Employee Jan 1, 2015
Operational/Managerial Control Jan 1, 2015

Practitioners & affiliated clinicians

Practitioners 1

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 11

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": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1659334167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035043",
            "telephone_number": "573-335-1281",
            "fax_number": "573-651-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 INDEPENDENCE ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035043",
            "telephone_number": "573-335-1281",
            "fax_number": "573-651-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE RETIREMENT COMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "BOELLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "573-651-8186"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "031333",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107809105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chateau Girardeau",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chateau Girardeau",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.