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JACKSON MANOR HEALTHCARE, LLC
NPI 1417662370
Skilled Nursing Facility in Jackson, MO

Active since January 16, 2023CLIA 26D0442080 · Waiver
4/5
Overall Rating
710 BROADRIDGE DR, JACKSON, MO 63755(573) 243-3101 Get Directions Write a Review

NPPES record last updated: January 16, 2023. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Jackson Manor Healthcare, Llc NPPES

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

JACKSON MANOR HEALTHCARE, LLC (NPI 1417662370), doing business as Jackson Manor, is a healthcare organization registered as a skilled nursing facility in Jackson, Missouri and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Judah Bienstock, Ceo, as its authorized official.

NPPES Registry Identity

NPI1417662370
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameJACKSON MANOR HEALTHCARE, LLC
Location Address710 BROADRIDGE DRJackson, MO 63755-3042
Mailing Address477 N Lindbergh Blvd Ste 310Saint Louis, MO 63141-7856 · (314) 631-3000
Phone(573) 243-3101
Organization SubpartNo
Authorized OfficialJudah BienstockCeo · (314) 631-3000
Enumeration DateJanuary 16, 2023
NPPES CertifiedJanuary 16, 2023
✔ NPI 1417662370 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.
710 BROADRIDGE DR, Jackson, MO 63755
Open in Google Maps ↗

Other Names 1

Doing Business AsJackson Manor

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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 26D0442080

Jackson Manor · Jackson, MO
Active · expires Aug 31, 2028
CLIA Number26D0442080
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorJoseph Starke
Laboratory Phone(573) 243-3101
Laboratory LocationJackson Manor710 Broadridge St, Jackson, MO 63755
CLIA data matches this NPI record on: 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 Jackson Manor (CMS certification number 265438), from CMS Care Compare.

Jackson Manor

Nursing home · Jackson, MO
4/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number265438
Certified Beds90 beds67 residents per day on average
Medicare & Medicaid Participant SinceOctober 1, 1990
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
3/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
3/5
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.
20
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 2.02 · LPN 0.51 · RN 0.39
2.92 hrs per resident per day
Weekend Nurse Staffing
2.34 hrs per resident per day
Physical Therapist Staffing
0.02 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
61.3%
Registered Nurse Turnover
77.8%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
1
Substantiated Complaints
0
Infection-Control Citations
0
Fines
1 totaling $650.00
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 6

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

MS. TAMARA L GOLDRICK LCSW
Social Worker (Clinical)
710 BROADRIDGE DR
JACKSON, MO 63755
Cape Girardeau County (888) 365-6271
RICHEL PINGKIAN
Occupational Therapist
710 BROADRIDGE DR
JACKSON, MO 63755
Cape Girardeau County (573) 243-4704
BUCKEYE J, LLC
Skilled Nursing Facility
710 BROADRIDGE DR
JACKSON, MO 63755
Cape Girardeau County (573) 243-3101
JUDY L HART
Occupational Therapy Assistant
710 BROADRIDGE DR
JACKSON, MO 63755
Cape Girardeau County (573) 243-3101
SARAH FYFE
Occupational Therapy Assistant
710 BROADRIDGE DR
JACKSON, MO 63755
Cape Girardeau County (573) 243-3101
IRENE LIM LO SUY COMSTOCK OTR/L
Occupational Therapist (Gerontology)
710 BROADRIDGE DR
JACKSON, MO 63755
Cape Girardeau County (573) 243-3101

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 Jackson Manor Healthcare, LLC's NPI number?

The NPI number for Jackson Manor Healthcare, LLC is 1417662370. It was assigned to this organization in the NPPES registry on January 16, 2023. The provider is doing business as Jackson Manor.

Where is Jackson Manor Healthcare, LLC located?

Jackson Manor Healthcare, LLC is located at 710 Broadridge Dr, Jackson, MO 63755. The listed phone number is (573) 243-3101.

What is Jackson Manor Healthcare, LLC's specialty?

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

Does Jackson Manor Healthcare, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0442080) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Jackson Manor Healthcare, LLC a Medicare-certified nursing home?

Yes. Jackson Manor is a Medicare-certified nursing home with 90 certified beds.

What quality rating does Jackson Manor Healthcare, LLC have?

CMS rates Jackson Manor 4 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Jackson Manor Healthcare, LLC accept?

Health plans from UnitedHealthcare list Jackson Manor Healthcare, 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 Jackson Manor Healthcare, LLC was last updated on January 16, 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.