CREVE COEUR MANOR LLC
NPI 1194806109
Skilled Nursing Facility in Saint Louis, MO

NPI Status: Active since October 17, 2006

Contact Information

1127 TIMBER RUN DR
SAINT LOUIS, MO
ZIP 63146
Phone: (314) 434-8361
Fax: (314) 434-7785

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  • Organization
  • Skilled Nursing Facility
  • CLIA Number: 26D0991754
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 09-26-2027

About CREVE COEUR MANOR LLC

This page provides the complete NPI Profile along with additional information for Creve Coeur Manor Llc, a provider established in Saint Louis, Missouri operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1194806109 assigned on October 2006. The practitioner's primary taxonomy code is 314000000X with license number 031651 (MO). The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Sharo Shirshekan (Managing Member)

NPI
1194806109
Provider Name
CREVE COEUR MANOR LLC
Entity Type
Organization
Location Address
1127 TIMBER RUN DR SAINT LOUIS, MO 63146
Location Phone
(314) 434-8361
Location Fax
(314) 434-7785
Mailing Address
1127 TIMBER RUN DR SAINT LOUIS, MO 63146
Mailing Phone
(314) 434-8361
Mailing Fax
(314) 434-7785
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-17-2006
Last Update Date
12-17-2013
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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

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
License No.
031651
License State
MO
Taxonomy Description
(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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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

SHARO SHIRSHEKAN

Authorized Official Title
MANAGING MEMBER
Authorized Official Phone
(573) 701-0600

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
265720MEDICARE OSCAR/CERTIFICATION (06)MO 
101486009MEDICAID (05)MO 

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
26D0991754
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 27, 2025
Certificate Expiration Date
September 26, 2027
Laboratory Director
CYNTHIA BARKER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Creve Coeur Manor Llc 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.

Reviews for CREVE COEUR MANOR LLC

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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 1194806109, we treat the final digit (9) 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 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

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
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
0
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
1
Unchanged
Pos 9
0
Doubled → 0
Check
9
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 9 → 18 → 9 8 → 16 → 7 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 8 + 4 + 1 + 6 + 0 + 1 + 2 + 1 + 0 + 24 = 51

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

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1194806109.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Physical Therapist
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Occupational Therapy Assistant
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Skilled Nursing Facility
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Skilled Nursing Facility
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146
Skilled Nursing Facility
1127 TIMBER RUN DR
SAINT LOUIS, MO 63146

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194806109, enumerated as an "organization" on October 17, 2006.

The provider is located at 1127 TIMBER RUN DR SAINT LOUIS, MO 63146 and the phone number is (314) 434-8361.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.