Shell Rock Healthcare Center Inc
Organization Active NPI Skilled Nursing Facility · Shell Rock, IA
NPI 1992793475 · NPPES record last updated Oct 14, 2008
Key facts
- NPI
- 1992793475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- N-086 (IA)
- Legal business name
- SHELL ROCK HEALTHCARE CENTER INC
- Practice address
- 920 N Cherry St
Shell Rock, IA 50670-9760 - Phone
- (319) 885-4341
- NPI assigned
- Oct 10, 2005
- Organization subpart
- No
Authorized official
- Name
- Howie Groff
- Title
- President
- Phone
- (952) 888-2923
Facilities with the same owner 31
Affiliated clinicians 3
-
Jodi Kay Walther, NP-C
Medicare Care Compare: Nursing home
- Listed as
- Shell Rock Senior Living
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1997
- Medicare certification status
- Active
- Certified beds
- 41 · 39.2 residents per day on average
- Chain
- Accura Healthcare
- Penalties (3 years)
- 1 · fines totaling $17,167
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D0647993 | Shell Rock Healthcare Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Skilled nursing facility certification: CCN 165309
- Legal name
- SHELL ROCK HEALTHCARE CENTER INC
- Doing business as
- SHELL ROCK SENIOR LIVING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1997
- Last certification
- Sep 15, 2024
- Beds
- 41
- Ownership / control type
- Corporation
- Multi-facility organization
- Accura Healthcare
- Organization structure
- Corporation · Proprietary
- Incorporated
- Mar 20, 1998 in MN
- Enrollment address
- 920 N Cherry St
Shell Rock, IA 50670-9760 - Nursing home name
- SHELL ROCK SENIOR LIVING
- Affiliated entity
- ACCURA HEALTHCARE
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| American Healthcare Management Services LLC |
Operational/Managerial Control | Oct 1, 2019 | 100% |
| Ted a Leneave |
Corporate Officer |
Oct 1, 2019 | |
| Operational/Managerial Control |
Oct 1, 2019 | ||
| Gail Sheridan |
5% Or Greater Indirect Ownership Interest |
Sep 3, 2008 | 50% |
| Corporate Officer | Sep 3, 2008 | ||
| Kassidy Spurgin |
W-2 Managing Employee |
Jan 1, 2023 | |
| Tealwood Enterprise Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2012 | 100% |
| Howard a Groff |
5% Or Greater Indirect Ownership Interest |
Sep 3, 2008 | 50% |
| Corporate Officer | Sep 3, 2008 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20021010000015 | IA | Part a Provider - Skilled Nursing Facility | 5294642864 | Practice locations: Shell Rock, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | N086 | IA | |
| Skilled Nursing Facility | 314000000X | N-086 | IA | Yes |
Addresses
Primary practice location
920 N Cherry St
Shell Rock, IA 50670-9760
Mailing address
920 N Cherry St
Shell Rock, IA 50670-9760
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108903 | Medicaid | IA | |
| 165309 | Other | IA | BLUE CROSS |
| 651190 | Other | IA | COMBINED INSURANCE |
Other providers in Shell Rock, IA
- City of Shell Rock
- Amber R Kramer
- Lara Lea Kyhl
- William Frank Maxwell
- Shell Rock Family Health LLC
- Roger Leland Skierka
- Traci L Skierka
- Waverly Health Center
All providers in Shell Rock, IA · Skilled Nursing Facility in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.