Gasconade Manor Nursing Home District

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

031054 Issued in MO

Legal business name

GASCONADE MANOR NURSING HOME DISTRICT

Practice address

1910 Nursing Home Road
Owensville, MO 65066-2844

Phone

(573) 437-4101

Fax

(573) 437-3925

NPI assigned

Jan 29, 2007

Last updated

Sep 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Crystal Lynn Ray, ADMINISTRATOR

Title

Administrator

Phone

(573) 437-4101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972649705. Details of each certification follow.

• CCN 265546 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 265546

Legal name

GASCONADE MANOR NURSING HOME DISTRICT

Doing business as

GASCONADE MANOR NURSING HOME

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1993

Last certification

May 31, 2024

Beds

79

Ownership / control type

Other Nonprofit

Organization structure

GovernmentNon-profit

Enrollment address

1910 Nursing Home Road
Owensville, MO 65066-2844

Nursing home name

GASCONADE MANOR NURSING HOME

Listed as

Gasconade Manor Nursing HomeCCN 265546 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

1 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Oct 1, 1993

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7959.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Gasconade Manor NH Home2 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.

• Gasconade Manor NRSG Home

  • Skilled Nursing Facility
  • Owensville, MO
  • NPI 1518949213
  NPD tax ID

All disclosed owners & managing parties 13

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

Owners & managing parties with NPI records 1

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

• Dustin Warbritton, D.O.

  • Family Medicine Physician
  • Jefferson City, MO
  • NPI 1093712275

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

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

• Redstone Presbyterian Senior Care

  • Skilled Nursing Facility
  • Greensburg, PA
  • NPI 1316945868

  Powerback Rehabilitation LLC

  CMS ownership
• Sunbridge Retirement Care Associates LLC

  dba Pembroke Care and Rehabilitation Center

  • Skilled Nursing Facility
  • Pembroke, NC
  • NPI 1194779504

  Powerback Rehabilitation LLC

  CMS ownership
• T-Street Holdings LLC

  • Skilled Nursing Facility
  • Cashmere, WA
  • NPI 1598234577

  Powerback Rehabilitation LLC

  CMS ownership

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.

• Dustin Warbritton, D.O.

  • Family Medicine Physician
  • Jefferson City, MO
  • NPI 1093712275
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Brian R Edwards, DO

  • Family Medicine Physician
  • Owensville, MO
  • NPI 1639147283

  Nursing home

  Care Compare affiliation
• Elaine Hobein, FNP-C

  • Family Nurse Practitioner
  • Owensville, MO
  • NPI 1396296265

  Nursing home

  Care Compare affiliation
• Dustin Warbritton, D.O.

  • Family Medicine Physician
  • Jefferson City, MO
  • NPI 1093712275

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1972649705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520",
            "address_2": "1910 NURSING HOME ROAD",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650660520",
            "telephone_number": "573-437-4101",
            "fax_number": "573-437-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 NURSING HOME ROAD",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650662844",
            "telephone_number": "573-437-4101",
            "fax_number": "573-437-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASCONADE MANOR NURSING HOME DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "573-437-4101",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "031054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian R Edwards, DO
• Eldercare of Mid-Missouri Xiv Inc. (StoneBridge Owensville)
• Kellie Christina Elmore, P.T.
• Gasconade County Board for Services for the Developmentally Disabled (Gasconade County Special Services)
• Gasconade Manor NRSG Home
• Gasconade Terrace Retirement Center
• Claire Glaser
• Emma Amalia Godat, DPT
• Marty Joseph Green, PTA
• Paige Hammer

• Skilled Nursing Facility in Owensville, MO
• Providers in Owensville, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.