Fountainbleau of Cape Girardeau Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030982 Issued in MO

Legal business name

FOUNTAINBLEAU OF CAPE GIRARDEAU INC.

Practice address

2001 N Kingshighway St
Cape Girardeau, MO 63701-2127

Phone

(573) 335-1999

NPI assigned

Oct 11, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Shafiq M Malik

Title

President

Phone

(573) 335-1999

Specialties & licenses 1

Addresses

Other names 1

• Fountainbleau Lodge Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Skilled nursing facility certification: CCN 265383

Legal name

FOUNTAINBLEAU OF CAPE GIRARDEAU INC

Doing business as

FOUNTAINBLEAU LODGE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 11, 1989

Last certification

Aug 8, 2024

Beds

33

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Enrollment address

2001 N Kingshighway St
Cape Girardeau, MO 63701-2127

Nursing home name

FOUNTAINBLEAU LODGE

Affiliated entity

SHAFIQ MALIK

Listed as

Fountainbleau LodgeCCN 265383

Overall star rating

5 of 5

Health inspections

4 of 5

Staffing

5 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 11, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3327.7 residents per day on average

Chain

Shafiq Malik9 facilities in the chain

Penalties (3 years)

1Fines totaling $8,827

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Fountainbleau Lodge2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fountainbleau of Cape Girardeau, Inc.

  • Assisted Living Facility
  • Cape Girardeau, MO
  • NPI 1831216589
  NPD tax ID

Locations

All disclosed owners & managing parties 8

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.

• Madhu Sahai, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Sikeston, MO
  • NPI 1972658979

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Madhu Sahai, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Sikeston, MO
  • NPI 1972658979
  NPD (past)

Affiliated clinicians 1

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

• Madhu Sahai, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Sikeston, MO
  • NPI 1972658979

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831187152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012127",
            "telephone_number": "573-335-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012127",
            "telephone_number": "573-335-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAINBLEAU OF CAPE GIRARDEAU INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "SHAFIQ",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-335-1999",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountainbleau Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natasha Ford
• Takaus Rochell Foreman
• Ryan P Fortner, FNP
• Dale H Foster, M.D.
• Reeanna May Foster, BS, MAADC II
• Fountainbleau of Cape Girardeau, Inc.
• Brianna Marie Fouts
• Christy M. Fowler, O.D.
• Trisha Fowler, APRN FNP
• Fox Family Dental LLC

• Skilled Nursing Facility in Cape Girardeau, MO
• Providers in Cape Girardeau, 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 Aug 22, 2020; 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.