PACIFIC MANOR LLC
NPI 1265091755
Skilled Nursing Facility in Pacific, MO

Active since June 10, 2019
105 S 6TH ST, PACIFIC, MO 63069(636) 271-4222(636) 257-8131 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Sep 15, 2025, Jun 10, 2019 (2 updates tracked since 2019).

About Pacific Manor Llc NPPES

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

PACIFIC MANOR LLC (NPI 1265091755), doing business as Pacific Manor, is a healthcare organization registered as a skilled nursing facility in Pacific, Missouri and active in the NPI registry since June 2019. The organization lists Carla Hedrick, Cfo, as its authorized official.

NPPES Registry Identity

NPI1265091755
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePACIFIC MANOR LLC
Location Address105 S 6TH STPacific, MO 63069-1328
Mailing Address1220 N Main StSikeston, MO 63801-4827 · (573) 481-9625 · Fax (573) 472-0098
Fax(636) 257-8131
Organization SubpartNo
Authorized OfficialCarla HedrickCfo · (573) 481-9625
Enumeration DateJune 10, 2019
Last NPPES UpdateSeptember 15, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2025
NPI 1265091755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
105 S 6TH ST, Pacific, MO 63069

Other Names 1

Doing Business AsPacific Manor

Other Identifiers 1

Medicaid102343001MO

Accepted 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 26D0437765

Pacific Manor LLC Dba Pacific Care Center · Pacific, MO
Expired · Aug 31, 2026
CLIA Number26D0437765
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSamantha Elliott-Reifsteck
Laboratory Phone(636) 271-4222
Laboratory LocationPacific Manor LLC Dba Pacific Care Center105 S 6th St, Pacific, MO 63069
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 4

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

Occupational Therapist
105 S 6TH ST
PACIFIC, MO 63069
Skilled Nursing Facility
105 S 6TH ST
PACIFIC, MO 63069
Occupational Therapy Assistant
105 S 6TH ST
PACIFIC, MO 63069
Physical Therapy Assistant
105 S 6TH ST
PACIFIC, MO 63069

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 Pacific Manor LLC's NPI number?

The NPI number for Pacific Manor LLC is 1265091755. It was assigned to this organization in the NPPES registry on June 10, 2019. The provider is doing business as Pacific Manor.

Where is Pacific Manor LLC located?

Pacific Manor LLC is located at 105 S 6th St, Pacific, MO 63069. The listed phone number is (636) 271-4222.

What is Pacific Manor LLC's specialty?

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

What insurance does Pacific Manor LLC accept?

Health plans from UnitedHealthcare list Pacific Manor LLC 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 Pacific Manor LLC was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.