NPIMap

Organization Active NPI

N & R of Lebanon North LLC

Doing business as Lebanon North Nursing & Rehab

  • Skilled Nursing Facility
  • Lebanon, MO
National Provider Identifier
1881091239
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
042568 Issued in MO
Legal business name
N & R OF LEBANON NORTH LLC
Doing business as
Lebanon North Nursing & Rehab
Practice address
596 Morton Rd
Lebanon, MO 65536-3648
Phone
(417) 532-9173
Fax
(417) 532-8223
NPI assigned
Dec 1, 2014
Last updated
Sep 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 042568 MO Primary

Addresses

Primary practice location

596 Morton Rd
Lebanon, MO 65536-3648

Mailing address

596 Morton Rd
Lebanon, MO 65536-3648
Phone (417) 532-9173

Other identifiers 1

IdentifierTypeStateIssuer
101489409MedicaidMO

Other names 1

  • LEBANON NORTH NURSING & REHAB Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 199.119.81.30:8291 Other eSolutions Inc

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150109001930 MO Part A Provider - Skilled Nursing Facility 7911221445 Practice locations: Lebanon, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881091239. Details of each certification follow.

Skilled nursing facility certification: CCN 265123

Legal name
N & R OF LEBANON NORTH LLC
Doing business as
LEBANON NORTH NURSING & REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1976
Last certification
May 23, 2024
Beds
180
Ownership / control type
Individual
Most recent change of ownership
Dec 1, 2014
Organization structure
LLCProprietary
Incorporated
Jul 1, 2014 in MO
Enrollment address
596 Morton Rd
Lebanon, MO 65536-3648
Nursing home name
LEBANON NORTH NURSING & REHAB
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lebanon North Nursing & RehabCCN 265123 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Jan 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
18078.4 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain
Penalties (3 years)
3Fines totaling $263,670

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Christian Health and Rehabilitation of Lebanon North2 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.

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
Elaine Fleetwood Individual W-2 Managing EmployeeAdministrator Apr 25, 2022 100%
LTC Management Services LLC Organization, Sikeston, MO Management services company Operational/Managerial Control Dec 1, 2014 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Dec 1, 2014 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Dec 1, 2014 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 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1881091239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 MORTON RD",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363648",
            "telephone_number": "417-532-9173",
            "fax_number": "417-532-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 MORTON RD",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363648",
            "telephone_number": "417-532-9173",
            "fax_number": "417-532-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N & R OF LEBANON NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "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",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "042568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101489409",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "199.119.81.30:8291",
            "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": "LEBANON NORTH NURSING & REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, MO

Sources for this page

Verify at the official NPI Registry.