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ST JOE MANOR INC
NPI 1144301144
Skilled Nursing Facility in Bonne Terre, MO

Active since October 17, 2006CLIA 26D0967414 · Waiver
10 LAKE DR, BONNE TERRE, MO 63628(573) 358-2800(573) 358-1090 Get Directions Write a Review

NPPES record last updated: March 21, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About St Joe Manor Inc NPPES

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

ST JOE MANOR INC (NPI 1144301144) is a healthcare organization registered as a skilled nursing facility in Bonne Terre, Missouri and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through November 11, 2027 and lists Sharo Shirshekan, President, as its authorized official.

NPPES Registry Identity

NPI1144301144
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameST JOE MANOR INC
Location Address10 LAKE DRBonne Terre, MO 63628-1820
Mailing Address10 Lake DrBonne Terre, MO 63628-1820 · (573) 358-2800 · Fax (573) 358-1090
Phone(573) 358-2800
Fax(573) 358-1090
Organization SubpartNo
Authorized OfficialSharo ShirshekanPresident · (573) 701-0600
Enumeration DateOctober 17, 2006
Last NPPES UpdateMarch 21, 2019
✔ NPI 1144301144 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in MO · 031997
Definition
(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.
10 LAKE DR, Bonne Terre, MO 63628
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Other Identifiers 1

Medicaid103256004MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

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 26D0967414

St Joe Manor · Bonne Terre, MO
Active · expires Nov 11, 2027
CLIA Number26D0967414
Laboratory TypeOther
Certificate Effective DateNovember 12, 2025
Certificate Expiration DateNovember 11, 2027
Laboratory DirectorRonald G. Robinson Jr
Laboratory Phone(573) 358-0282
Laboratory LocationSt Joe Manor10 Lake Drive, Bonne Terre, MO 63628
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHEYENNE SPURGIN PTA
Physical Therapy Assistant
10 LAKE DR
BONNE TERRE, MO 63628
St. Francois County (573) 359-2800
MISSOURI REHAB, LLC
Clinic/Center (Rehabilitation)
10 LAKE DR
BONNE TERRE, MO 63628
St. Francois County (573) 335-3044
TIFFANY ARNOLD FNP
Nurse Practitioner (Family)
10 LAKE DR
BONNE TERRE, MO 63628
St. Francois County (636) 297-5025
RACHEL M RAYBURN FNP-C
Nurse Practitioner (Family)
10 LAKE DR
BONNE TERRE, MO 63628
St. Francois County (573) 358-2800

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 St Joe Manor Inc's NPI number?

The NPI number for St Joe Manor Inc is 1144301144. It was assigned to this organization in the NPPES registry on October 17, 2006.

Where is St Joe Manor Inc located?

St Joe Manor Inc is located at 10 Lake Dr, Bonne Terre, MO 63628. The listed phone number is (573) 358-2800.

What is St Joe Manor Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does St Joe Manor Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0967414) is associated with this NPI, valid through November 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Joe Manor Inc accept?

Health plans from UnitedHealthcare list St Joe Manor Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for St Joe Manor Inc was last updated on March 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.