NPIMap

Organization Active NPI

Eldercare of Mid-Missouri X, Inc

  • Skilled Nursing Facility
  • Jefferson City, MO
National Provider Identifier
1982901609
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ELDERCARE OF MID-MISSOURI X, INC
Practice address
1024 Adams St
Jefferson City, MO 65101-3408
Phone
(573) 635-1320
Fax
(573) 634-3944
NPI assigned
Feb 15, 2011
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Mark Lierman
Title
Authorized Official
Phone
(636) 477-3280

Owners & managing parties with NPI records 1

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

Facilities with the same owner 11

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

Practitioners 2

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.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Stonebridge Adams StreetCCN 265810
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 10, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12048.5 residents per day on average
Chain
Stonebridge Senior Living12 facilities in the chain
Penalties (3 years)
1Fines totaling $38,656

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
26D1064547Adams Street - a Stonebridge Comm1024 Adams Street, Jefferson City, MO 65101Certificate of waiverFeb 7, 2027

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110315000473 MO Part a Provider - Skilled Nursing Facility 2668654484 Practice locations: Jefferson City, MO

Skilled nursing facility certification: CCN 265810

Medicare enrollment files
Legal name
ELDERCARE OF MID-MISSOURI X INC
Doing business as
STONEBRIDGE ADAMS STREET
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 10, 2007
Last certification
Dec 4, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
STONEBRIDGE SENIOR LIVING
Most recent change of ownership
Jan 1, 2011
Organization structure
CorporationProprietary
Enrollment address
1024 Adams St
Jefferson City, MO 65101-3408
Nursing home name
STONEBRIDGE ADAMS STREET
Affiliated entity
STONEBRIDGE SENIOR LIVING

All disclosed owners & managing parties 14

Medicare enrollment files

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

NameRoleSinceShare
Beth Miller Individual Corporate OfficerSecretary Jan 17, 2023
Dustin Warbritton Individual Operational/Managerial Control Jan 1, 2011
Adp of the SNF Jan 1, 2011
Keri White Individual Operational/Managerial Control Aug 19, 2023
Adp of the SNF Aug 19, 2023
Eric Doerhoff Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Lierman Family Co X, LLC Organization, Saint Charles, MO LLC Adp of the SNF Jan 1, 2011
Enterprise Bank & Trust Organization, Clayton, MO Financial institution Operational/Managerial Control May 30, 2008
Eldercare Management Services Inc Organization, Saint Charles, MO Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Aug 17, 2010
Adp of the SNF Apr 22, 2025
Jeanne Thayer Individual Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Wipfli LLP Organization, Clayton, MO Adp of the SNF Jan 1, 2025
Bridge Rehabilitation Inc Organization, Saint Charles, MO Corporation, Medical provider/supplier Operational/Managerial Control Feb 1, 2024
Adp of the SNF Apr 22, 2025
Kara Knight Individual Operational/Managerial Control Mar 1, 2018
Adp of the SNF Mar 1, 2018
Mark W Lierman Individual 5% Or Greater Direct Ownership InterestPresident Nov 1, 2021 100%
Corporate OfficerPresident Nov 1, 2021 100%
Operational/Managerial Control Nov 1, 2021
Adp of the SNF Nov 1, 2021
Forvis Mazars LLP Organization, Springfield, MO Consulting firm Adp of the SNF Jan 25, 2016
Steven Ciegel Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X MO Primary

Addresses

NPPES NPI Registry

Primary practice location

1024 Adams St
Jefferson City, MO 65101-3408

Mailing address

1024 Adams St
Jefferson City, MO 65101-3408
Phone (636) 477-3280

Other names 1

NPPES NPI Registry
  • StoneBridge Adams Street Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 1, 2020.

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1982901609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 ADAMS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013408",
            "telephone_number": "636-477-3280",
            "fax_number": "636-477-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 ADAMS ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013408",
            "telephone_number": "573-635-1320",
            "fax_number": "573-634-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE OF MID-MISSOURI X, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "LIERMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "636-477-3280",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StoneBridge Adams Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.