MEMORY LANE OF DEXTER
NPI 1366997678
Skilled Nursing Facility in Dexter, MO

Active since August 17, 2016CLIA 26D0442232 · Waiver
3/5
Overall Rating
415 S CATALPA ST, DEXTER, MO 63841(573) 624-7491(573) 624-2061 Get Directions Write a Review

NPPES record last updated: April 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 13, 2023, Aug 17, 2016 (2 updates tracked since 2016).

About Memory Lane Of Dexter NPPES

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

MEMORY LANE OF DEXTER (NPI 1366997678) is a healthcare organization registered as a skilled nursing facility in Dexter, Missouri and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Benjamin P Sells, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366997678
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMEMORY LANE OF DEXTER, LLC
Location Address415 S CATALPA STDexter, MO 63841-2017
Mailing Address415 S Catalpa StDexter, MO 63841-2017 · (573) 624-7491 · Fax (573) 624-2061
Fax(573) 624-2061
Organization SubpartNo
Authorized OfficialBenjamin P SellsCeo · (573) 614-7472
Enumeration DateAugust 17, 2016
Last NPPES UpdateApril 13, 20232 updates tracked since enumeration
NPPES CertifiedApril 13, 2023
NPI 1366997678 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.
415 S CATALPA ST, Dexter, MO 63841

Other Names 1

Doing Business AsMemory Lane Of Dexter

Other Identifiers 1

Medicaid101456309MO

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 26D0442232

Memory Lane Of Dexter · Dexter, MO
Active · expires Aug 31, 2026
CLIA Number26D0442232
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorLogan L. Quertermous
Laboratory Phone(573) 624-7491
Laboratory LocationMemory Lane Of Dexter415 S Catalpa Street, Dexter, MO 63841
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Memory Lane Of Dexter (CMS certification number 265382), from CMS Care Compare.

Memory Lane Of Dexter

Nursing home · Dexter, MO
3/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number265382
Certified Beds73 beds61 residents per day on average
Medicare & Medicaid Participant SinceSeptember 1, 1989
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
2/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
1/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
40
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.24 · LPN 0.72 · RN 0.22
3.17 hrs per resident per day
Weekend Nurse Staffing
2.61 hrs per resident per day
Physical Therapist Staffing
0.04 hrs per resident per day
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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 Memory Lane Of Dexter, LLC's NPI number?

The NPI number for Memory Lane Of Dexter, LLC is 1366997678. It was assigned to this organization in the NPPES registry on August 17, 2016. The provider is doing business as Memory Lane Of Dexter.

Where is Memory Lane Of Dexter, LLC located?

Memory Lane Of Dexter, LLC is located at 415 S Catalpa St, Dexter, MO 63841. The listed phone number is (573) 624-7491.

What is Memory Lane Of Dexter, LLC's specialty?

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

Does Memory Lane Of Dexter, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0442232) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Memory Lane Of Dexter, LLC a Medicare-certified nursing home?

Yes. Memory Lane Of Dexter is a Medicare-certified nursing home with 73 certified beds.

What quality rating does Memory Lane Of Dexter, LLC have?

CMS rates Memory Lane Of Dexter 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Memory Lane Of Dexter, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield and UnitedHealthcare list Memory Lane Of Dexter, 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 Memory Lane Of Dexter, LLC was last updated on April 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.