NPIMap

Organization Active NPI

Country Meadows Nursing & Rehab LLC

Doing business as Country Meadows

  • Skilled Nursing Facility
  • Park Hills, MO
National Provider Identifier
1821179789
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
032557 Issued in MO
Legal business name
COUNTRY MEADOWS NURSING & REHAB LLC
Doing business as
Country Meadows
Practice address
1301 North Saint Joe Drive
Park Hills, MO 63601-1965
Phone
(573) 431-2889
Fax
(573) 431-2822
NPI assigned
Oct 18, 2006
Last updated
Aug 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carla Hedrick
Title
Cfo
Phone
(573) 481-9625

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 032558 MO
Skilled Nursing Facility 314000000X 032557 MO Primary

Addresses

Primary practice location

1301 North Saint Joe Drive
Park Hills, MO 63601-1965

Mailing address

1301 North Saint Joe Drive
Park Hills, MO 63601-1965
Phone (573) 431-2889

Other identifiers 2

IdentifierTypeStateIssuer
267889103MedicaidMO
102534500MedicaidMO

Other names 1

  • Country Meadows Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080318000512 MO Part A Provider - Skilled Nursing Facility 4789760604 Practice locations: Park Hills, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821179789. Details of each certification follow.

Skilled nursing facility certification: CCN 265734

Legal name
COUNTRY MEADOWS NURSING & REHAB LLC
Doing business as
COUNTRY MEADOWS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 29, 2002
Last certification
May 23, 2024
Beds
72
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jun 1, 2003 in MO
Enrollment address
1301 N Saint Joe Dr
Park Hills, MO 63601-1965
Nursing home name
COUNTRY MEADOWS
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Country MeadowsCCN 265734 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 29, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7264.2 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly B Thomas Individual W-2 Managing EmployeeAdministrator Oct 1, 2003 100%
LTC Management Services LLC Organization, Sikeston, MO Management services company Operational/Managerial Control Sep 24, 2014 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Jan 16, 2008 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Jan 16, 2008 50%

Facilities with the same owner 36

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 36

Practitioners & affiliated clinicians

Practitioners 4

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.

Affiliated clinicians 1

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1821179789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 NORTH SAINT JOE DRIVE",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636011965",
            "telephone_number": "573-431-2889",
            "fax_number": "573-431-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 NORTH SAINT JOE DRIVE",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636011965",
            "telephone_number": "573-431-2889",
            "fax_number": "573-431-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY MEADOWS NURSING & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "HEDRICK",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "573-481-9625"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MO",
            "license": "032558",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "032557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267889103",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102534500",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Country Meadows",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Hills, MO

Sources for this page

Verify at the official NPI Registry.