NPIMap

Organization Active NPI

Presbyterian Manors, Inc.

  • Skilled Nursing Facility
  • Rolla, MO
National Provider Identifier
1861503302
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
030022 Issued in MO
Legal business name
PRESBYTERIAN MANORS, INC.
Practice address
1200 Homelife PLZ
Rolla, MO 65401-2512
Phone
(573) 364-7336
Fax
(573) 364-7495
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Authorized official

Name
Mr. William M Ward Jr.
Title
President/Ceo
Phone
(316) 685-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 030022 MO Primary

Addresses

Primary practice location

1200 Homelife PLZ
Rolla, MO 65401-2512

Mailing address

PO Box 20440
Wichita, KS 67208-1440
Phone (316) 685-1100

Other identifiers 1

IdentifierTypeStateIssuer
700170OtherKSBLUE CROSS

Other names 1

  • Rolla Presbyterian Manor Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040426000704 MO Part A Provider - Skilled Nursing Facility 1254242639 Practice locations: Rolla, MO

Skilled nursing facility certification: CCN 265580

Legal name
PRESBYTERIAN MANORS INC
Doing business as
ROLLA PRESBYTERIAN MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1994
Last certification
Mar 6, 2025
Beds
30
Ownership / control type
Nonprofit Corporation
Multi-facility organization
PRESBYTERIAN MANORS INC
Organization structure
CorporationNon-profit
Incorporated
Dec 28, 1948 in KS
Enrollment address
1200 Homelife PLZ
Rolla, MO 65401-2512
Nursing home name
ROLLA PRESBYTERIAN MANOR
Affiliated entity
PRESBYTERIAN MANORS OF MID-AMERICA

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Care Compare: Nursing home

Medicare Care Compare
Listed as
Rolla Presbyterian ManorCCN 265580
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3027.2 residents per day on average
Chain
Presbyterian Manors of Mid-America13 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0668342Rolla Presbyterian Manor1200 Homelife Plaza, Rolla, MO 65401Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Manor15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Eleanor a Nelson Individual Corporate DirectorBoard Member Jul 1, 2010
John H Goodwin Individual Corporate DirectorBoard Member Jul 1, 2018
Aaron Morrison Individual Corporate DirectorBoard Member Jul 1, 2015
William Taylor Individual Corporate OfficerCoo Jul 1, 2015
James Cook Individual Corporate DirectorBoard Member Jul 1, 2012
Presbyterian Manors of Mid-America Inc Organization, Wichita, KS Non-profit Operational/Managerial Control Mar 30, 1989
Presbyterian Manors Inc Organization, Wichita, KS Non-profit 5% Or Greater Direct Ownership Interest Mar 30, 1989 100%
Melanie Owens Individual Corporate OfficerCfo Jul 10, 2017
Ann M Caudill Individual Corporate DirectorExecutive Director Mar 31, 2011
W-2 Managing EmployeeExecutive Director Mar 31, 2011
Elizabeth McKell Individual Corporate DirectorBoard Member Jul 1, 2012
Joan M Miller Individual Corporate OfficerController/Asst Treasurer Sep 1, 1997
Sherry K Hind Individual Corporate OfficerCorporate Secretary Jul 1, 1989
Gary D Brennecke Individual Corporate DirectorBoard Member Jul 1, 2015
Bruce H Shogren Individual Corporate OfficerCeo/President Aug 5, 1996

Owners & managing parties with NPI records 13

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 13

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Topeka Presbyterian ManorTopeka, KS, CCN 175297 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Clay Center Presbyterian ManorClay Center, KS, CCN 175310 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Emporia Presbyterian ManorEmporia, KS, CCN 175304 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Newton Presbyterian ManorNewton, KS, CCN 175302 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Lawrence Presbyterian ManorLawrence, KS, CCN 175305 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Manor of the PlainsDodge City, KS, CCN 175306 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Farmington Presbyterian ManorFarmington, MO, CCN 265583 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Parsons Presbyterian ManorParsons, KS, CCN 175303 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Arkansas City Presbyterian ManorArkansas City, KS, CCN 175309 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Wichita Presbyterian ManorWichita, KS, CCN 175301 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Salina Presbyterian ManorSalina, KS, CCN 175300 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Mar 30, 1989
Aberdeen VillageOlathe, KS, CCN 175448 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2015

Owned or controlled facilities with NPI records 12

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203638400000",
    "number": "1861503302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20440",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672081440",
            "telephone_number": "316-685-1100",
            "fax_number": "316-685-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HOMELIFE PLZ",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012512",
            "telephone_number": "573-364-7336",
            "fax_number": "573-364-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MANORS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-22",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "316-685-1100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "030022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "700170",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rolla Presbyterian Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.