Organization Active NPI

Jefferson Health Care Inc

  • Skilled Nursing Facility
  • Lees Summit, MO
National Provider Identifier
1891728770
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
045063 Issued in MO
Legal business name
JEFFERSON HEALTH CARE INC
Practice address
615 SW Oldham Pkwy
Lees Summit, MO 64081-2602
Phone
(816) 524-3328
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Authorized official

Name
Cliff Shirrell
Title
Vice President
Phone
(573) 471-1276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 045063 MO Primary

Addresses

Primary practice location

615 SW Oldham Pkwy
Lees Summit, MO 64081-2602

Mailing address

PO Box 1210
Sikeston, MO 63801-1210

Other identifiers 1

IdentifierTypeStateIssuer
101456705MedicaidMO

Other names 1

  • Jefferson Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614001040 MO Part A Provider - Skilled Nursing Facility 9335183987 Practice locations: Lees Summit, MO

Skilled nursing facility certification: CCN 265377

Legal name
JEFFERSON HEALTH CARE INC
Doing business as
JEFFERSON HEALTH CARE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 24, 1989
Last certification
Apr 4, 2025
Beds
120 (118 certified)
Ownership / control type
Corporation
Multi-facility organization
CASTLE PARTNERS
Organization structure
CorporationProprietary
Enrollment address
615 SW Oldham Pkwy
Lees Summit, MO 64081-2602
Nursing home name
JEFFERSON HEALTH CARE
Affiliated entity
CIRCLE B ENTERPRISES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jefferson Health CareCCN 265377
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 - Corporation
Certified
Apr 24, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11870.9 residents per day on average
Chain
Circle B Enterprises36 facilities in the chain
Penalties (3 years)
2Fines totaling $34,459

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
26D0715636Jefferson Health Care615 SW Oldham Pky, Lees Summit, MO 64081Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Sovereign Healthcare Group LLC Organization, Sikeston, MO LLC, Medical provider/supplier Operational/Managerial Control Apr 23, 2021
Adp of the SNF Apr 6, 2025
Ramilo I Gatapia Individual Operational/Managerial Control Mar 14, 2011
Adp of the SNF Mar 14, 2011
FG LLC Organization, Sikeston, MO LLC Adp of the SNF Dec 2, 2016
Mid States Inc Organization, Sikeston, MO Corporation, Management services company Adp of the SNF Nov 1, 2010
Individual Adp of the SNF Jan 1, 2000
Van de Ven LLC Organization, Cape Girardeau, MO LLC Adp of the SNF Jan 1, 2000
Lees Properties LLC Organization, Sikeston, MO LLC Adp of the SNF Jan 1, 2010
Circle B Enterprises Holding Company Inc Organization, Sikeston, MO Holding company 5% Or Greater Direct Ownership Interest Jan 1, 1996 100%
Todd Beaird Individual Corporate OfficerSecretary Jan 1, 2022
Adp of the SNF Jan 25, 2022
Donald B Bedell Individual Corporate OfficerPresident Jan 6, 1997
Corporate DirectorPresident Oct 31, 2000
Operational/Managerial Control Jan 1, 1997
Individual Adp of the SNF Jan 1, 2000
DCB Real Estate Partnership LP Organization, Sikeston, MO Adp of the SNF Apr 11, 2025
Sara Hyatt Individual Operational/Managerial Control Feb 6, 2026
Adp of the SNF Feb 6, 2026
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Adp of the SNF Aug 16, 2021
Agh1 LLC Organization, Sikeston, MO LLC, Management services company, Consulting firm Operational/Managerial Control Dec 2, 2016
Adp of the SNF Mar 26, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 41

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

View all 41

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1891728770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SW OLDHAM PKWY",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640812602",
            "telephone_number": "816-524-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "SHIRRELL",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "045063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101456705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.