St Clair Nursing LLC
Organization Active NPI Skilled Nursing Facility · Saint Clair, MO
NPI 1841297645 · NPPES record last updated Jan 29, 2013
Key facts
- NPI
- 1841297645
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 030993 (MO)
- Legal business name
- ST CLAIR NURSING LLC
- Practice address
- 1035 Plaza CT North
Saint Clair, MO 63077-1129 - Phone
- (636) 629-2100
- Fax
- (636) 629-7793
- NPI assigned
- Jul 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. James Reiker
- Title
- Treasurer
- Phone
- (573) 471-1113
Owners & managing parties with NPI records 1
Member of 1
Facilities with the same owner 23
Practitioners 1
-
Shaukat A Thanawalla, M.D.
Affiliated clinicians 3
-
Pooja Patil, MD
-
Sanjay Sharma, DO
-
Shaukat A Thanawalla, M.D.
Medicare Care Compare: Nursing home
- Listed as
- St Clair Nursing Center
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★★ 5 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 1, 1992
- Medicare certification status
- Active
- Certified beds
- 79 · 55.3 residents per day on average
- Chain
- Americare Senior Living
- Penalties (3 years)
- 1 · fines totaling $12,735
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D0716436 | St Clair Nursing Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Skilled nursing facility certification: CCN 265495
- Legal name
- ST. CLAIR NURSING LLC
- Doing business as
- ST CLAIR NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1992
- Last certification
- Feb 7, 2025
- Beds
- 79
- Ownership / control type
- Corporation
- Multi-facility organization
- AMERICARE
- Most recent change of ownership
- Jan 1, 2003
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 1, 2002 in DE
- Enrollment address
- 1035 Plaza CT N
St Clair, MO 63077-1129 - Nursing home name
- ST CLAIR NURSING CENTER
- Affiliated entity
- AMERICARE SENIOR LIVING
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Clay Crosson |
Other |
Mar 7, 2013 | 100% |
| Richard Henley Montgomery |
Corporate Officer |
Aug 1, 1981 | 100% |
| Corporate Director | Jan 16, 2003 | ||
| Kyle Schade |
Contracted Managing Employee |
Mar 1, 2021 | |
| Corporate Officer |
Mar 1, 2021 | ||
| Denice Marsh |
W-2 Managing Employee |
Aug 15, 2016 | 100% |
| James Edward Reiker |
Contracted Managing Employee |
Apr 1, 2002 | |
| Corporate Officer |
Apr 1, 2002 | ||
| W-2 Managing Employee | Jan 1, 2003 | ||
| Americare Systems, Inc. |
Operational/Managerial Control | Apr 4, 2002 | 100% |
| Anna C Montgomery |
5% Or Greater Indirect Ownership Interest | Jan 1, 2013 | 50% |
| St. Clair Nursing LLC |
5% Or Greater Direct Ownership Interest | Jan 1, 2003 | |
| R H Montgomery Properties, Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2003 | |
| Steven P Hatlestad |
Operational/Managerial Control |
Apr 1, 2002 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030116000014 | MO | Part a Provider - Skilled Nursing Facility | 5294643011 | Practice locations: St Clair, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 030993 | MO | Yes |
Addresses
Primary practice location
1035 Plaza CT North
Saint Clair, MO 63077-1129
Mailing address
1035 Plaza CT N
Saint Clair, MO 63077-1129
Phone (636) 629-2100
Other names
- St Clair Nursing Center
Other providers in Saint Clair, MO
- Natalie Schroeder
- Amanda Slater
- Patrick Raymond Smith
- St Clair Allergy-Asthma
- St Clair Family Dentistry
- St Clair Physical Therapy Inc
- St Clair Rexall Drug Store
- St. Clair Ambulance District
- St. Clair Reorganized District R-Xiii
- Jennifer Kaye Stenger
All providers in Saint Clair, MO · Skilled Nursing Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2013. 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.