Mountain Grove 2 Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

044753 Issued in MO

Legal business name

MOUNTAIN GROVE 2 INC

Doing business as

Autumn Oaks Caring Center

Practice address

1310 N Hovis St
Mountain Grove, MO 65711-1219

Phone

(417) 926-5128

NPI assigned

Jul 7, 2006

Last updated

Apr 30, 2021By 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

• Autumn Oaks Caring Center 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 1669404638. Details of each certification follow.

• CCN 265406 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265406

Legal name

MOUNTAIN GROVE 2 INC

Doing business as

AUTUMN OAKS CARING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 22, 1989

Last certification

Jan 10, 2025

Beds

120

Ownership / control type

Individual

Organization structure

CorporationProprietary

Enrollment address

1310 N Hovis St
Mountain Grove, MO 65711-1219

Nursing home name

AUTUMN OAKS CARING CENTER

Affiliated entity

CIRCLE B ENTERPRISES

Listed as

Autumn Oaks Caring CenterCCN 265406 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Individual

Certified

Dec 22, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12068.3 residents per day on average

Chain

Circle B Enterprises36 facilities in the chain

Penalties (3 years)

2Fines totaling $48,539

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 14

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.

• Jonathan Robert Beers, DO

  • Internal Medicine Physician
  • Rolla, MO
  • NPI 1477783686

  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
• Ellington 1 Inc

  dba Brent B Tinnin Manor

  • Skilled Nursing Facility
  • Ellington, MO
  • NPI 1629000690

  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

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.

• Jonathan Robert Beers, DO

  • Internal Medicine Physician
  • Rolla, MO
  • NPI 1477783686
  NPD (past)

Affiliated clinicians 1

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

• Jonathan Robert Beers, DO

  • Internal Medicine Physician
  • Rolla, MO
  • NPI 1477783686

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1669404638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N MAIN ST",
            "address_2": "PO BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638012151",
            "telephone_number": "573-471-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N HOVIS ST",
            "city": "MOUNTAIN GROVE",
            "state": "MO",
            "postal_code": "657111219",
            "telephone_number": "417-926-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN GROVE 2 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "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": "044753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101472603",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Oaks Caring Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy St Francis Hospital (Mercy Clinic Family Medicine-Mountain Grove)
• Alexis Mills, PA-C
• Moore Family Eyecare, LLC
• Douglas Loran Moore, OD
• Jade Moore, APRN, FNP-C
• Mountain Grove Medical and Laser Center Inc
• Mountain Grove Medical and Laser Center Inc
• Mountain Grove Pharmacy Inc (Mountain Grove Pharmacy)
• Mountain Grove R-III School District
• Ashley Myers, LMSW

• Skilled Nursing Facility in Mountain Grove, MO
• Providers in Mountain Grove, 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 Apr 30, 2021; 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.