Salt River Nursing Home District

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030709 Issued in MO

Legal business name

SALT RIVER NURSING HOME DISTRICT

Doing business as

Salt River Community Care

Practice address

142 Shelby Plaza Rd
Shelbina, MO 63468-1065

Phone

(573) 588-4175

Fax

(573) 588-2020

NPI assigned

Sep 8, 2005

Last updated

Feb 17, 2010By 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

Mrs. Elizabeth Youse

Title

Administrator

Phone

(573) 588-4175

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Salt River Community Care 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 1801880547. Details of each certification follow.

• CCN 265694 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265694

Legal name

SALT RIVER NURSING HOME DISTRICT

Doing business as

SALT RIVER COMMUNITY CARE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1998

Last certification

Sep 13, 2023

Beds

120

Ownership / control type

County

Organization structure

OtherNon-profit

Enrollment address

142 Shelby Plaza Rd
Shelbina, MO 63468-1065

Nursing home name

BAPTIST HOMES OF SHELBINA

Listed as

Baptist Homes of ShelbinaCCN 265694 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Jul 1, 1998

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

12058.5 residents per day on average

Penalties (3 years)

1Fines totaling $20,695

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 9

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 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mark Anthony Angles, M.D.

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1568554517

  Adp of the SNF

  CMS ownership

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.

• Mark Anthony Angles, M.D.

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1568554517
  NPD (past)
• Abdullah Arshad, MD

  • Internal Medicine Physician
  • Hayti, MO
  • NPI 1477660637
  NPD (past)

Affiliated clinicians 6

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

• Mark Anthony Angles, M.D.

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1568554517

  Nursing home

  Care Compare affiliation
• Richard Leo Baumann Jr., M.D.

  • Orthopaedic Surgery Physician
  • Hannibal, MO
  • NPI 1124028188

  Nursing home

  Care Compare affiliation
• Curtis Dale Burton, M.D.

  • Orthopaedic Surgery Physician
  • Hannibal, MO
  • NPI 1013917061

  Nursing home

  Care Compare affiliation
• Ashley Marie Lanpher, RN BSN APRN FNP-C

  • Family Nurse Practitioner
  • Monroe City, MO
  • NPI 1245828714

  Nursing home

  Care Compare affiliation
• Byron Bus Tarbox, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Columbia, MO
  • NPI 1629061205

  Nursing home

  Care Compare affiliation
• Rodney Lynn Yager, D.O.

  • Family Medicine Physician
  • Hannibal, MO
  • NPI 1851321202

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266364800000",
    "number": "1801880547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 SHELBY PLAZA RD",
            "city": "SHELBINA",
            "state": "MO",
            "postal_code": "634681065",
            "telephone_number": "573-588-4175",
            "fax_number": "573-588-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 SHELBY PLAZA RD",
            "city": "SHELBINA",
            "state": "MO",
            "postal_code": "634681065",
            "telephone_number": "573-588-4175",
            "fax_number": "573-588-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT RIVER NURSING HOME DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2010-02-17",
        "status": "A",
        "authorized_official_last_name": "YOUSE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-588-4175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101776904",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salt River Community Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendell Allan Nickerson, D.O.
• David F. Ouellette, M.D.
• Barbara B Russell, DDS
• Wesley A Russell II, DDS
• Kelly M Sadler, PT, DPT
• Shelbina Pharmacy L L C
• Shelbina Village Estates, Inc
• Shelby County R-IV Schools
• Shelby County Senior Citizens Assocation Inc
• Shelby County Senior Citizens Association Inc.

• Skilled Nursing Facility in Shelbina, MO
• Providers in Shelbina, 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 Feb 17, 2010; 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.