GOOD SHEPHERD CARE CENTER NPI 1811905904

NPI Information

  • NPI: 1811905904
  • Provider Name: GOOD SHEPHERD CARE CENTER
  • Classification: Skilled Nursing Facility - 314000000X
  • Entity Type: Organization
  • CLIA Number: 26D0678085
  • Address: 1101 W CLAY RD
    VERSAILLES, MO
    ZIP 65084
  • Phone: (573) 378-5411

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NPI Details

GOOD SHEPHERD CARE CENTER is a skilled nursing facility in Versailles, MO. The provider is (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. GOOD SHEPHERD CARE CENTER NPI is 1811905904. The provider is registered as an organization entity type.

The provider's business location address is:

1101 W CLAY RD
VERSAILLES, MO
ZIP 65084-314
Phone: (573) 378-5411
Fax: (573) 378-5415

The provider's authorized official is Rebecca May Mathiot .
The authorized official title is Financial Manager and has the following contact phone number (573) 378-5411.

The CLIA number assigned to this NPI record is 26D0678085 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2006 and was last updated on 12/6/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QX0100XClinic/CenterOccupational MedicineNo
2261QP2000XClinic/CenterPhysical TherapyNo
3314000000XSkilled Nursing Facility031255MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1101487502MEDICAIDMISSOURI
2124739OTHERMISSOURIHEALTHLINK
3110693OTHERMISSOURIBLUE CROSS OF MISSOURI
4265528MEDICARE OSCAR/CERTIFICATIONMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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