CLARK COUNTY NURSING HOME
NPI 1194718908
Skilled Nursing Facility in Kahoka, MO

NPI Status: Active since August 26, 2005

Contact Information

1260 N JOHNSON ST
KAHOKA, MO
ZIP 63445
Phone: (660) 727-3303
Fax: (660) 727-3736

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 26D0652124
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About CLARK COUNTY NURSING HOME

This page provides the complete NPI Profile along with additional information for Clark County Nursing Home, a provider established in Kahoka, Missouri operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1194718908 assigned on August 2005. The practitioner's primary taxonomy code is 314000000X with license number 035239 (MO). The provider is registered as an organization and their NPI record was last updated 16 years ago. The authorized official of this NPI record is Ms. Tammy Mcdaniel-ramsey R.n. (Administrator)

NPI
1194718908
Provider Name
CLARK COUNTY NURSING HOME
Entity Type
Organization
Location Address
1260 N JOHNSON ST KAHOKA, MO 63445
Location Phone
(660) 727-3303
Location Fax
(660) 727-3736
Mailing Address
1260 N JOHNSON ST KAHOKA, MO 63445
Mailing Phone
(660) 727-3303
Mailing Fax
(660) 727-3736
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-26-2005
Last Update Date
07-31-2009
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
035239
License State
MO
Taxonomy Description
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. TAMMY MCDANIEL-RAMSEY R.N.

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(660) 727-3303

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
101483709MEDICAID (05)MO 
265485MEDICARE OSCAR/CERTIFICATION (06)MO 
261483705MEDICAID (05)MO 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D0652124
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
JEFFREY DAVIS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Clark County Nursing Home to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for CLARK COUNTY NURSING HOME

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1194718908
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
211841411690
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 1 + 8 + 4 + 1 + 4 + 1 + 1 + 6 + 9 + 0 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1194718908 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1952708703 LAURA WINTERS PTA
Individual
Physical Therapy Assistant1260 N JOHNSON ST
KAHOKA, MO 63445
(660) 727-9024
1851765960 JESSICA DIANNE BOUDREAU COTA/L
Individual
Occupational Therapy Assistant1260 N JOHNSON ST
KAHOKA, MO 63445
(660) 727-3303

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194718908, enumerated in the NPI registry as an "organization" on August 26, 2005

The provider is located at 1260 N Johnson St Kahoka, Mo 63445 and the phone number is (660) 727-3303

This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 26D0652124 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on August 26, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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