BRISTOL MANOR OF REPUBLIC
NPI 1144436114
Assisted Living Facility in Republic, MO

NPI Status: Active since May 15, 2007

Contact Information

634 E STATE HIGHWAY 174
REPUBLIC, MO
ZIP 65738
Phone: (417) 732-8998
Fax: (417) 732-8998

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 26D0967589
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 11-16-2027

About BRISTOL MANOR OF REPUBLIC

This page provides the complete NPI Profile along with additional information for Bristol Manor Of Republic, a provider established in Republic, Missouri operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1144436114 assigned on May 2007. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 19 years ago. The provider's other name is Bristol Manor Of Republic. The authorized official of this NPI record is Shelley D Ebeling (Medicaid Billing Department)

NPI
1144436114
Provider Legal Name
BRISTOL CARE, INC.
Other Organization Name
BRISTOL MANOR OF REPUBLIC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
634 E STATE HIGHWAY 174 REPUBLIC, MO 65738
Location Phone
(417) 732-8998
Location Fax
(417) 732-8998
Mailing Address
201 W 3RD ST SEDALIA, MO 65301
Mailing Phone
(660) 826-0200
Mailing Fax
(417) 732-8998
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-15-2007
Last Update Date
10-03-2007
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

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

SHELLEY D EBELING

Authorized Official Title
MEDICAID BILLING DEPARTMENT
Authorized Official Phone
(660) 826-0200

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
26D0967589
Facility Type
Assisted Living Facility
Certificate Effective Date
November 17, 2025
Certificate Expiration Date
November 16, 2027
Laboratory Director
JESSICA WRIGHT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Bristol Manor Of Republic 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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1144436114, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
4
Doubled → 8
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
1
Unchanged
Pos 9
1
Doubled → 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 6 → 12 → 3 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 8 + 4 + 8 + 3 + 1 + 2 + 1 + 2 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1144436114.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1144436114, enumerated as an "organization" on May 15, 2007.

The provider is located at 634 E STATE HIGHWAY 174 REPUBLIC, MO 65738 and the phone number is (417) 732-8998.

Assisted Living Facility with taxonomy code 310400000X.