Ashley Manor Health & Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ASHLEY MANOR HEALTH & REHABILITATION LLC

Practice address

1630 Radio Hill Rd
Boonville, MO 65233-1957

Phone

(660) 882-6584

Fax

(660) 882-2267

NPI assigned

Jul 5, 2023

Last updated

Jul 26, 2023By 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

Chaim Mandelbaum

Title

Manager

Phone

(660) 882-6584

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811675440. Details of each certification follow.

• CCN 265738 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265738

Legal name

ASHLEY MANOR HEALTH & REHABILITATION LLC

Doing business as

ASHLEY MANOR HEALTH & REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

May 14, 2002

Last certification

Jan 15, 2025

Beds

52

Ownership / control type

Limited Liability Corporation

Multi-facility organization

BEACON HEALTHCARE GROUP

Most recent change of ownership

Jul 1, 2023

Organization structure

LLCProprietary

Enrollment address

1630 Radio Hill Rd
Boonville, MO 65233-1957

Nursing home name

ASHLEY MANOR HEALTH & REHABILITATION

Affiliated entity

MO OP HOLDCO, LLC

Listed as

Ashley Manor Health & RehabilitationCCN 265738 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

2 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

May 14, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5247.9 residents per day on average

Chain

Mo Op Holdco, LLC9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 35

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.

• Eric A. Barnes, D.O.

  • Internal Medicine Physician
  • Columbia, MO
  • NPI 1619952520

  Adp of the SNF, Operational/Managerial Control

  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.

• Carrie M Peecher, DO

  • Family Medicine Physician
  • Marshall, MO
  • NPI 1699070052
  NPD (past)
• Catherine M Vanvoorn, M.D.

  • Internal Medicine Physician
  • Columbia, MO
  • NPI 1720054448
  NPD (past)

Affiliated clinicians 2

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

• Carrie M Peecher, DO

  • Family Medicine Physician
  • Marshall, MO
  • NPI 1699070052

  Nursing home

  Care Compare affiliation
• Catherine M Vanvoorn, M.D.

  • Internal Medicine Physician
  • Columbia, MO
  • NPI 1720054448

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1811675440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 RADIO HILL RD",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331957",
            "telephone_number": "660-882-6584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 RADIO HILL RD",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331957",
            "telephone_number": "660-882-6584",
            "fax_number": "660-882-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY MANOR HEALTH & REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "MANDELBAUM",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "660-882-6584"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Marie Aldrich, MSRDLD
• Shelby A Angel, MED, LPC
• Peggy Moser Armentrout, PHARMACIST
• Kellie Marie Asher, DPT
• Ashley Manor, Inc. (Ashley Manor Care Center)
• Elizabeth Anne Atkinson, LPC
• Axis Chiropractic LLC
• Patrick C Beglau, LPC
• Jeff Birdsong, O.D.

• Skilled Nursing Facility in Boonville, MO
• Providers in Boonville, 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 Jul 26, 2023; 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.