Active NPI
Carriage Operator LLC
Doing business as Carriage Square Rehab and Healthcare Center
- Skilled Nursing Facility
- Saint Joseph, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CARRIAGE OPERATOR LLC
- Doing business as
- Carriage Square Rehab and Healthcare Center
- Practice address
- 4009 Gene Field Rd
Saint Joseph, MO 64506-1864 - Phone
- (816) 364-1526
- NPI assigned
- Aug 5, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacques Wolf
- Title
- Manager
- Phone
- (908) 421-1184
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
4009 Gene Field Rd
Saint Joseph, MO 64506-1864
Mailing address
10 Grandview Dr
Lakewood, NJ 08701-3881
Other names 1
- Carriage Square Rehab and Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211110001746 | MO | Part A Provider - Skilled Nursing Facility | 7618366774 | Practice locations: Saint Joseph, MO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1780358473. Details of each certification follow.
Skilled nursing facility certification: CCN 265336
- Legal name
- CARRIAGE OPERATOR LLC
- Doing business as
- CARRIAGE SQUARE REHAB AND HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1989
- Last certification
- Mar 14, 2025
- Beds
- 130
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- LUXOR LLC
- Most recent change of ownership
- Oct 19, 2021
- Organization structure
- LLC
- Incorporated
- Jun 22, 2021 in MO
- Enrollment address
- 4009 Gene Field Road
Saint Joseph, MO 64506-1864 - Nursing home name
- CARRIAGE SQUARE REHAB AND HEALTHCARE CENTER
- Affiliated entity
- AMA HOLDINGS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Carriage Square Rehab and Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 1, 1989
- Medicare certification status
- Active
- Certified beds
- 130
- Chain
- Ama Holdings
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 6
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Asher Marx | 5% Or Greater Indirect Ownership Interest | Oct 19, 2021 | 50% |
| Corporate Director | Oct 19, 2021 | 50% | |
| Def Holdings LLC | 5% Or Greater Indirect Ownership Interest | Oct 19, 2021 | 50% |
| Mo Operation Holdings de Spe LLC | 5% Or Greater Direct Ownership Interest | Jan 25, 2024 | 99% |
| Operational/Managerial Control | Jan 25, 2024 | 99% | |
| Amy J Byrom | W-2 Managing Employee | Oct 1, 2021 | |
| Jacques Wolf | 5% Or Greater Indirect Ownership Interest | Oct 19, 2021 | 50% |
| Corporate Director | Oct 19, 2021 | 50% | |
| Ama Holdings LLC | 5% Or Greater Indirect Ownership Interest | Oct 19, 2021 | 50% |
Facilities with the same owner 12
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Beauvais Rehab and Healthcare Center
- Skilled Nursing Facility
- Saint Louis, MO
- NPI 1285308031
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
-
dba Butler Rehab and Healthcare Center
- Skilled Nursing Facility
- Butler, MO
- NPI 1619669645
Ama Holdings LLC, Def Holdings LLC
-
dba Country Club Rehab and Healthcare Center
- Skilled Nursing Facility
- Warrensburg, MO
- NPI 1104584416
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
-
dba Crown Rehab and Healthcare Center
- Skilled Nursing Facility
- Harrisonville, MO
- NPI 1073271383
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
-
dba Manchester Rehab and Healthcare Center
- Skilled Nursing Facility
- Ballwin, MO
- NPI 1730871765
Ama Holdings LLC, Def Holdings LLC
-
dba New Mark Rehab and Healthcare Center
- Skilled Nursing Facility
- Kansas City, MO
- NPI 1750114880
Ama Holdings LLC, Def Holdings LLC
-
dba Rancho Rehab and Healthcare Center
- Skilled Nursing Facility
- Florissant, MO
- NPI 1821762691
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
-
dba River Crossing Rehab and Healthcare Center
- Skilled Nursing Facility
- Saint Louis, MO
- NPI 1144094608
Ama Holdings LLC, Def Holdings LLC
-
dba Rosewood Rehab and Healthcare Center
- Skilled Nursing Facility
- Independence, MO
- NPI 1669146361
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
-
dba Seasons Rehab and Healthcare Center
- Skilled Nursing Facility
- Kansas City, MO
- NPI 1861166563
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
-
dba St Peters Rehab and Healthcare Center
- Skilled Nursing Facility
- Saint Peters, MO
- NPI 1861254948
Ama Holdings LLC, Def Holdings LLC
-
dba Wilshire at Lakewood Rehab Center
- Skilled Nursing Facility
- Lee's Summit, MO
- NPI 1972261287
Ama Holdings LLC, Def Holdings LLC, Mo Operation Holdings de Spe LLC
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Saint Joseph, MO
- NPI 1326501867
-
- Internal Medicine Physician
- Saint Joseph, MO
- NPI 1629339122
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": "1628121600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1628121600000",
"number": "1780358473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 GRANDVIEW DR",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087013881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4009 GENE FIELD RD",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645061864",
"telephone_number": "816-364-1526"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CARRIAGE OPERATOR LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-05",
"last_updated": "2021-08-05",
"certification_date": "2021-08-05",
"status": "A",
"authorized_official_last_name": "WOLF",
"authorized_official_first_name": "JACQUES",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "908-421-1184"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Carriage Square Rehab and Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Saint Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.