Nazareth Living Center
Organization Active NPI Skilled Nursing Facility · Saint Louis, MO
NPI 1689780330 · NPPES record last updated Nov 22, 2023
Key facts
- NPI
- 1689780330
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- NAZARETH LIVING CENTER
- Practice address
- 2 Nazareth Lane
Saint Louis, MO 63129-7600 - Phone
- (314) 487-3950
- Fax
- (314) 487-8001
- NPI assigned
- Aug 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Julie Collins
- Title
- Administrator
- Phone
- (314) 396-5686
Facilities with the same owner 27
Practitioners 1
-
Sirisha Vaddi Brosch, M.D.
Affiliated clinicians 2
-
Sirisha Vaddi Brosch, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Nazareth Living Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- May 1, 1996
- Medicare certification status
- Active
- Certified beds
- 121 · 92.7 residents per day on average
- Chain
- Benedictine Health System
- Penalties (3 years)
- 2 · fines totaling $11,928
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0721617 | Nazareth Living Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Skilled nursing facility certification: CCN 265636
- Legal name
- NAZARETH LIVING CENTER
- Doing business as
- NAZARETH LIVING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- May 1, 1996
- Last certification
- Mar 14, 2025
- Beds
- 121
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- BENEDICTINE HEALTH
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 19, 1987 in MO
- Enrollment address
- 2 Nazareth LN
Saint Louis, MO 63129-7600 - Nursing home name
- NAZARETH LIVING CENTER
- Affiliated entity
- BENEDICTINE HEALTH SYSTEM
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Sisters of St Joseph of Carondelet St Louis Province |
5% Or Greater Direct Ownership Interest | Jul 1, 2009 | 50% |
| Deborah Rapp |
Corporate Director |
Jul 1, 2016 | |
| Marie Harris |
Corporate Director |
Jul 1, 2015 | |
| Beverly Deblois |
Corporate Director |
Jul 1, 2020 | |
| Kevin J Rymanowski |
Corporate Director |
Jan 1, 2011 | |
| Tricia Bergien |
Corporate Officer |
Aug 23, 2017 | |
| Michael Haywood |
Corporate Director |
Jul 1, 2017 | |
| Elaine S Moore |
Corporate Director |
Oct 1, 2011 | |
| Mary Kay Hadican |
Corporate Director |
Jun 30, 2014 | |
| Fred Lutzeier |
Corporate Director |
Jul 1, 2018 | |
| Gerald Carley |
Operational/Managerial Control |
Dec 18, 2017 | |
| Sean J Hogan |
Corporate Director |
Jul 1, 2019 | |
| Jennifer Bruhn |
Corporate Director |
Jul 1, 2020 | |
| Leonard J Essig |
Corporate Director |
Jun 30, 2014 | |
| Robert a Ludwig |
Corporate Director |
Jun 30, 2014 | |
| Julie Collins |
Contracted Managing Employee |
Aug 9, 2021 | |
| Benedictine Health System |
5% Or Greater Direct Ownership Interest | Jul 1, 2009 | 50% |
| Operational/Managerial Control | Jul 1, 2009 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100811000392 | MO | Part a Provider - Skilled Nursing Facility | 2466586565 | Practice locations: Saint Louis, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | MO | Yes |
Addresses
Primary practice location
2 Nazareth Lane
Saint Louis, MO 63129-7600
Mailing address
2 Nazareth Lane
Saint Louis, MO 63129-7600
Phone (314) 487-3950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107807802 | Medicaid | MO |
Other providers in Saint Louis, MO
- Juveria Nayeem
- Adam David Naylor
- Kelly Jeannine Naylor
- Lindsey Nicole Naylor
- Patricia Y Naylor
- Neelofur Nazeer
- Arash Nazeri
- Maisa A Nazzal
- Mustafa D.M Nazzal
- Ashley Nazzoli
All providers in Saint Louis, MO · Skilled Nursing Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.