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BRISTOL MANOR OF ODESSA
NPI 1124234315
Assisted Living Facility in Odessa, MO

Active since May 15, 2007CLIA 26D0982851 · Waiver
115 S 5TH ST, ODESSA, MO 64076(816) 633-8692(816) 633-8692 Get Directions Write a Review

NPPES record last updated: October 3, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bristol Manor Of Odessa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRISTOL MANOR OF ODESSA (NPI 1124234315) is a healthcare organization registered as an assisted living facility in Odessa, Missouri and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through February 6, 2027 and lists Shelley D Ebeling, Medicaid Billing Department, as its authorized official.

NPPES Registry Identity

NPI1124234315
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBRISTOL CARE, INC.
Location Address115 S 5TH STOdessa, MO 64076-1330
Mailing Address201 W 3rd StSedalia, MO 65301-4352 · (660) 826-0200 · Fax (660) 827-2027
Phone(816) 633-8692
Fax(816) 633-8692
Organization SubpartNo
Authorized OfficialShelley D EbelingMedicaid Billing Department · (660) 826-0200
Enumeration DateMay 15, 2007
Last NPPES UpdateOctober 3, 2007
✔ NPI 1124234315 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
115 S 5TH ST, Odessa, MO 64076
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Other Names 1

Other NameBristol Manor Of Odessa

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0982851

Bristol Manor Of Odessa · Odessa, MO
Active · expires Feb 6, 2027
CLIA Number26D0982851
Laboratory TypeAssisted Living Facility
Certificate Effective DateFebruary 7, 2025
Certificate Expiration DateFebruary 6, 2027
Laboratory DirectorCandi Haworth
Laboratory Phone(816) 633-8692
Laboratory LocationBristol Manor Of Odessa115 S 5th, Odessa, MO 64076
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bristol Care, Inc.'s NPI number?

The NPI number for Bristol Care, Inc. is 1124234315. It was assigned to this organization in the NPPES registry on May 15, 2007. The provider is also known as Bristol Manor Of Odessa.

Where is Bristol Care, Inc. located?

Bristol Care, Inc. is located at 115 S 5th St, Odessa, MO 64076. The listed phone number is (816) 633-8692.

What is Bristol Care, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Bristol Care, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0982851) is associated with this NPI, valid through February 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bristol Care, Inc. was last updated on October 3, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.