The Ambassador Lincoln, Inc.
Organization Active NPI Skilled Nursing Facility · Lincoln, NE
NPI 1811901259 · NPPES record last updated Aug 17, 2018
Key facts
- NPI
- 1811901259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 504002 (NE)
- Legal business name
- THE AMBASSADOR LINCOLN, INC.
- Practice address
- 4405 Normal Blvd
Lincoln, NE 68506-5551 - Phone
- (402) 488-2355
- Fax
- (402) 488-2779
- NPI assigned
- Jul 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Marcia K Schroeder
- Title
- Chief Executive Officer
- Phone
- (402) 873-7791
Owners & managing parties with NPI records 2
-
Sean G Barry, M.D.
-
Arif A Sattar, M.D.
Facilities with the same owner 3
Practitioners 2
-
Sean G Barry, M.D.
-
Arif A Sattar, M.D.
Affiliated clinicians 1
-
Sean G Barry, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Ambassador Health of Lincoln
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 24, 1984
- Medicare certification status
- Active
- Certified beds
- 122 · 81.2 residents per day on average
- Chain
- Ambassador Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Skilled nursing facility certification: CCN 285066
- Legal name
- THE AMBASSADOR LINCOLN, INC.
- Doing business as
- AMBASSADOR HEALTH LINCOLN
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 24, 1984
- Last certification
- Nov 13, 2024
- Beds
- 122
- Ownership / control type
- Corporation
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 4405 Normal Blvd
Lincoln, NE 68506-5551 - Nursing home name
- AMBASSADOR HEALTH OF LINCOLN
- Affiliated entity
- AMBASSADOR HEALTH
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Apr 16, 2025 | |
| The Ambassador Group Inc |
Operational/Managerial Control | Feb 9, 1981 | |
| Adp of the SNF | Apr 16, 2025 | ||
| Tyler J Juilfs |
5% Or Greater Indirect Ownership Interest | Dec 30, 2024 | 5% |
| Corporate Officer | Jul 1, 2021 | ||
| Corporate Director | Jul 1, 2021 | ||
| Adp of the SNF | Dec 30, 2024 | ||
| |
Adp of the SNF | Apr 16, 2025 | |
| |
Adp of the SNF | Apr 16, 2025 | |
| Sally Juilfs |
5% Or Greater Indirect Ownership Interest | Jun 5, 1985 | 44% |
| Corporate Officer | Jun 5, 1985 | ||
| Corporate Director | Jun 5, 1985 | ||
| Adp of the SNF | Jun 5, 1985 | ||
| Indirect Ownership Interest | Jun 5, 1985 | 44% | |
| Tyler Stoupa |
Operational/Managerial Control | Mar 10, 2025 | |
| Brandy Filliez |
Operational/Managerial Control | Sep 1, 2024 | |
| Adp of the SNF | Apr 16, 2025 | ||
| Ambassador Holding Company |
5% Or Greater Direct Ownership Interest | Jun 5, 1985 | 100% |
| Adp of the SNF | Jun 5, 1985 | ||
| Direct Ownership Interest | Jun 5, 1985 | 100% | |
| First National Bank Omaha |
5% Or Greater Mortgage Interest | Jan 30, 2018 | 48% |
| Adp of the SNF | Apr 16, 2025 | ||
| |
Adp of the SNF | Apr 16, 2025 | |
| |
Adp of the SNF | Apr 16, 2025 | |
| Brent B Shanholtz |
Operational/Managerial Control |
Jan 1, 2013 | |
| |
Adp of the SNF | Apr 16, 2025 | |
| |
Adp of the SNF | Apr 16, 2025 | |
| Timothy Juilfs |
5% Or Greater Indirect Ownership Interest | Jun 5, 1985 | 44% |
| Corporate Officer | Jun 5, 1985 | ||
| Corporate Director | Jun 5, 1985 | ||
| Adp of the SNF | Jun 5, 1985 | ||
| Indirect Ownership Interest | Jun 5, 1985 | 44% | |
| Sean G Barry |
Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Jan 30, 2025 | ||
| |
Adp of the SNF | Apr 16, 2025 | |
| |
Adp of the SNF | Apr 16, 2025 | |
| Arif a Sattar |
Operational/Managerial Control | Jan 1, 2024 | |
| Adp of the SNF | Jan 30, 2025 | ||
| |
Adp of the SNF | Apr 16, 2025 | |
| Michael D. Lange |
Operational/Managerial Control | Dec 9, 2021 | |
| Adp of the SNF | Jan 30, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091211000137 | NE | Part a Provider - Skilled Nursing Facility | 6709926470 | Practice locations: Lincoln, NE |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 504002 | NE | |
| Occupational Therapist |
225X00000X | 504002 | NE | |
| Speech-Language Pathologist |
235Z00000X | 504002 | NE | |
| Skilled Nursing Facility | 314000000X | 504002 | NE | Yes |
Addresses
Primary practice location
4405 Normal Blvd
Lincoln, NE 68506-5551
Mailing address
4405 Normal Blvd
Lincoln, NE 68506-5551
Phone (402) 873-8507
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0659797 | Medicaid | IA |
Other providers in Lincoln, NE
- Benjamin Thayer
- Elizabeth Thayer
- Heather Victoria Thayer
- Sernay Thayusoe
- The Ambassador Lincoln
- The Ambassador Physicians Center Inc
- The Board of Regents of the University of Nebraska
- The Body Lab, LLC
- The Body Shoppe LLC
- The Bridge Behavioral Health, Inc.
All providers in Lincoln, NE · Skilled Nursing Facility in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2018. 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.