NORTH VILLAGE PARK
NPI 1821085655
Skilled Nursing Facility in Moberly, MO

Active since October 06, 2005CLIA 26D0446609 · Waiver
1/5
Overall Rating
2041 SILVA LN, MOBERLY, MO 65270(660) 263-1894(660) 263-0751 Get Directions Write a Review

NPPES record last updated: May 30, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About North Village Park NPPES

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

NORTH VILLAGE PARK (NPI 1821085655) is a healthcare organization registered as a skilled nursing facility in Moberly, Missouri and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Ashwin Dundoo, Finance, as its authorized official.

NPPES Registry Identity

NPI1821085655
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameNORTH VILLAGE PARK, LLC
Location Address2041 SILVA LNMoberly, MO 65270-3658
Mailing Address1869 Craig Park CtSaint Louis, MO 63146-4122 · (314) 543-3800 · Fax (314) 543-3880
Fax(660) 263-0751
Organization SubpartNo
Authorized OfficialAshwin DundooFinance · (314) 543-3800
Enumeration DateOctober 6, 2005
Last NPPES UpdateMay 30, 2013
NPI 1821085655 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.
2041 SILVA LN, Moberly, MO 65270

Other Names 1

Other NameNorth Village Park

Other Identifiers 2

Medicaid102561404MO
Medicare OSCAR/certification265330MO

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 26D0446609

North Village Park · Moberly, MO
Active · expires Aug 31, 2026
CLIA Number26D0446609
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKevin Williams
Laboratory Phone(660) 263-1894
Laboratory LocationNorth Village Park2041 Silva Ln, Moberly, MO 65270
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 North Village Park (CMS certification number 265330), from CMS Care Compare.

North Village Park

Nursing home · Moberly, MO
1/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number265330
Certified Beds183 beds172 residents per day on average
Medicare & Medicaid Participant SinceJuly 1, 1988
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
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.
727.83
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 0.83 · LPN 0.25 · RN 0.08
1.16 hrs per resident per day
Weekend Nurse Staffing
1.07 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
60.8%
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.
CMS lists this facility in its Special Focus Facility program, which identifies nursing homes with a persistent pattern of inspection issues for increased oversight.
Facility-Reported Incidents
25
Substantiated Complaints
33
Infection-Control Citations
0
Fines
5 totaling $292,019.00
Medicare Payment Denials
2
Total Penalties
7
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

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

Skilled Nursing Facility
2041 SILVA LN
MOBERLY, MO 65270

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 North Village Park, LLC's NPI number?

The NPI number for North Village Park, LLC is 1821085655. It was assigned to this organization in the NPPES registry on October 6, 2005. The provider is also known as North Village Park.

Where is North Village Park, LLC located?

North Village Park, LLC is located at 2041 Silva Ln, Moberly, MO 65270. The listed phone number is (660) 263-1894.

What is North Village Park, LLC's specialty?

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

Does North Village Park, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0446609) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is North Village Park, LLC a Medicare-certified nursing home?

Yes. North Village Park is a Medicare-certified nursing home with 183 certified beds.

What quality rating does North Village Park, LLC have?

CMS rates North Village Park 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for North Village Park, LLC was last updated on May 30, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.