MISSOURI ONE OPCO LLC
NPI 1831057587
Skilled Nursing Facility in Saint Louis, MO

Active since January 12, 2026CLIA 26D0680332 · Waiver
10954 KENNERLY RD, SAINT LOUIS, MO 63128(314) 843-4242(314) 843-4031 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Missouri One Opco Llc NPPES

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

MISSOURI ONE OPCO LLC (NPI 1831057587), doing business as Fountain Care At Sunset Hills, is a healthcare organization registered as a skilled nursing facility in Saint Louis, Missouri and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through April 27, 2027 and lists Menachem Kofman, Manager, as its authorized official.

NPPES Registry Identity

NPI1831057587
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMISSOURI ONE OPCO LLC
Location Address10954 KENNERLY RDSaint Louis, MO 63128-2018
Mailing Address10954 Kennerly RdSaint Louis, MO 63128-2018 · (314) 843-4242 · Fax (314) 843-4031
Fax(314) 843-4031
Organization SubpartNo
Authorized OfficialMenachem KofmanManager · (917) 533-4361
Enumeration DateJanuary 12, 2026
NPPES CertifiedJanuary 12, 2026
NPI 1831057587 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.
10954 KENNERLY RD, Saint Louis, MO 63128

Other Names 1

Doing Business AsFountain Care At Sunset Hills

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 26D0680332

Missouri One Opco LLC D/B/A Fountain Care At Sunset Hills · Saint Louis, MO
Active · expires Apr 27, 2027
CLIA Number26D0680332
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 28, 2025
Certificate Expiration DateApril 27, 2027
Laboratory DirectorTony Tang
Laboratory Phone(314) 843-4242
Laboratory LocationMissouri One Opco LLC D/B/A Fountain Care At Sunset Hills10954 Kennerly Rd, Saint Louis, MO 63128
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 9

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

Physical Therapist
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Physical Therapist
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Skilled Nursing Facility
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Internal Medicine
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Internal Medicine
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Skilled Nursing Facility
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Social Worker (Clinical)
10954 KENNERLY RD
SAINT LOUIS, MO 63128
Speech-Language Pathologist
10954 KENNERLY RD
SAINT LOUIS, MO 63128

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 Missouri One Opco LLC's NPI number?

The NPI number for Missouri One Opco LLC is 1831057587. It was assigned to this organization in the NPPES registry on January 12, 2026. The provider is doing business as Fountain Care at Sunset Hills.

Where is Missouri One Opco LLC located?

Missouri One Opco LLC is located at 10954 Kennerly Rd, Saint Louis, MO 63128. The listed phone number is (314) 843-4242.

What is Missouri One Opco LLC's specialty?

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

Does Missouri One Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0680332) is associated with this NPI, valid through April 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Missouri One Opco LLC was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.