1. Home
  2. Directory
  3. Missouri
  4. Kahoka
  5. Skilled Nursing Facility
  6. NPI Profile

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

Active since August 26, 2005CLIA 26D0652124 · Waiver
1260 N JOHNSON ST, KAHOKA, MO 63445(660) 727-3303(660) 727-3736 Get Directions Write a Review

NPPES record last updated: July 31, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Clark County Nursing Home NPPES

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

CLARK COUNTY NURSING HOME (NPI 1194718908) is a healthcare organization registered as a skilled nursing facility in Kahoka, Missouri and active in the NPI registry since August 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Tammy Mcdaniel-ramsey, Administrator, as its authorized official.

NPPES Registry Identity

NPI1194718908
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCLARK COUNTY NURSING HOME
Location Address1260 N JOHNSON STKahoka, MO 63445-1100
Mailing Address1260 N Johnson StKahoka, MO 63445-1100 · (660) 727-3303 · Fax (660) 727-3736
Phone(660) 727-3303
Fax(660) 727-3736
Organization SubpartNo
Authorized OfficialTammy Mcdaniel-ramseyAdministrator · (660) 727-3303
Enumeration DateAugust 26, 2005
Last NPPES UpdateJuly 31, 2009
✔ NPI 1194718908 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 · 035239
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.
1260 N JOHNSON ST, Kahoka, MO 63445
Open in Google Maps ↗

Other Identifiers 3

Medicaid101483709MO
Medicare OSCAR/certification265485MO
Medicaid261483705MO

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 26D0652124

Clark County Nursing Home · Kahoka, MO
Active · expires Aug 31, 2026
CLIA Number26D0652124
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJeffrey Davis
Laboratory Phone(660) 727-3303
Laboratory LocationClark County Nursing Home1260 N Johnson St, Kahoka, MO 63445
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

JESSICA DIANNE BOUDREAU COTA/L
Occupational Therapy Assistant
1260 N JOHNSON ST
KAHOKA, MO 63445
Clark County (660) 727-3303
LAURA WINTERS PTA
Physical Therapy Assistant
1260 N JOHNSON ST
KAHOKA, MO 63445
Clark County (660) 727-9024

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 Clark County Nursing Home's NPI number?

The NPI number for Clark County Nursing Home is 1194718908. It was assigned to this organization in the NPPES registry on August 26, 2005.

Where is Clark County Nursing Home located?

Clark County Nursing Home is located at 1260 N Johnson St, Kahoka, MO 63445. The listed phone number is (660) 727-3303.

What is Clark County Nursing Home's specialty?

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

Does Clark County Nursing Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0652124) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clark County Nursing Home was last updated on July 31, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.