NPIMap

Organization Active NPI

N & R of Columbia, LLC

Doing business as Parkside Manor

  • Skilled Nursing Facility
  • Columbia, MO
National Provider Identifier
1912090564
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
034974 Issued in MO
Legal business name
N & R OF COLUMBIA, LLC
Doing business as
Parkside Manor
Practice address
1201 Hunt Avenue
Columbia, MO 65202-1367
Phone
(573) 449-1448
Fax
(573) 443-2591
NPI assigned
Oct 2, 2006
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 034974 MO Primary

Addresses

Primary practice location

1201 Hunt Avenue
Columbia, MO 65202-1367

Mailing address

1201 Hunt Ave
Columbia, MO 65202-1367
Phone (573) 449-1448

Other identifiers 1

IdentifierTypeStateIssuer
102234507MedicaidMO

Other names 1

  • Parkside Manor 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
O20080327000745 MO Part A Provider - Skilled Nursing Facility 7719063973 Practice locations: Columbia, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912090564. Details of each certification follow.

Skilled nursing facility certification: CCN 265302

Legal name
N & R OF COLUMBIA, LLC
Doing business as
PARKSIDE MANOR
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 17, 1986
Last certification
Dec 19, 2024
Beds
120
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jan 1, 2008
Organization structure
LLCProprietary
Incorporated
Jan 1, 2008 in MO
Enrollment address
1201 Hunt Ave
Columbia, MO 65202-1367
Nursing home name
PARKSIDE MANOR
Affiliated entity
JAMES & JUDY LINCOLN

Care Compare: Nursing home

Medicare Care Compare
Listed as
Parkside ManorCCN 265302 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 17, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12077.7 residents per day on average
Chain
James & Judy Lincoln56 facilities in the chain
Penalties (3 years)
1Fines totaling $0

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
26D0994858Parkside Manor1201 Hunt Avenue, Columbia, MO 65202Certificate of waiverJan 2, 2028

National Provider Directory

National Provider Directory

Locations

1201 Hunt Ave
Columbia, MO 65202
Phone (573) 449-1448

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
Elizabeth Bowles Individual W-2 Managing Employee Oct 1, 2021
LTC Management Services LLC Organization, Sikeston, MO Management services company Operational/Managerial Control May 21, 2015 100%
James C Lincoln Individual 5% Or Greater Direct Ownership Interest Jan 1, 2008 50%
Judy L Lincoln Individual 5% Or Greater Direct Ownership Interest Jan 1, 2008 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.

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1912090564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HUNT AVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021367",
            "telephone_number": "573-449-1448",
            "fax_number": "573-443-2591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HUNT AVENUE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021367",
            "telephone_number": "573-449-1448",
            "fax_number": "573-443-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N & R OF COLUMBIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "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": "034974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102234507",
            "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": "Parkside Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.