HICKORY MANOR
NPI 1912424607
Skilled Nursing Facility in Licking, MO

Active since August 24, 2017
2/5
Overall Rating
209 HICKORY ST, LICKING, MO 65542(573) 674-2111 Get Directions Write a Review

NPPES record last updated: August 24, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 24, 2018, May 4, 2018, Aug 24, 2017 (3 updates tracked since 2017).

About Hickory Manor NPPES

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

HICKORY MANOR (NPI 1912424607) is a healthcare organization registered as a skilled nursing facility in Licking, Missouri and active in the NPI registry since August 2017. The organization lists Donald B Bedell, President, as its authorized official.

NPPES Registry Identity

NPI1912424607
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLICKING NO 1 LLC
Location Address209 HICKORY STLicking, MO 65542
Mailing Address731 N Main StSikeston, MO 63801-2151 · (573) 471-1276
Organization SubpartNo
Authorized OfficialDonald B BedellPresident · (573) 471-1276
Enumeration DateAugust 24, 2017
Last NPPES UpdateAugust 24, 20183 updates tracked since enumeration
NPI 1912424607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MO · 046854
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.
209 HICKORY ST, Licking, MO 65542

Other Names 1

Doing Business AsHickory Manor

Accepted Insurance

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Hickory Manor (CMS certification number 265632), from CMS Care Compare.

Hickory Manor

Nursing home · Licking, MO
2/5 CMS Overall Rating
OwnershipFor profit - Individual
CMS Certification Number265632
Certified Beds60 beds45 residents per day on average
Medicare & Medicaid Participant SinceApril 3, 1996
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.
56
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 2.08 · LPN 0.71 · RN 0.37
3.16 hrs per resident per day
Weekend Nurse Staffing
2.43 hrs per resident per day
Physical Therapist Staffing
0.01 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
82.2%
Registered Nurse Turnover
87.5%
Administrators Who Have Left
In the past year.
2
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
3
Infection-Control Citations
0
Fines
1 totaling $3,250.00
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 2

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

Skilled Nursing Facility
209 HICKORY ST
LICKING, MO 65542
Speech-Language Pathologist
209 HICKORY ST
LICKING, MO 65542

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 Licking No 1 LLC's NPI number?

The NPI number for Licking No 1 LLC is 1912424607. It was assigned to this organization in the NPPES registry on August 24, 2017. The provider is doing business as Hickory Manor.

Where is Licking No 1 LLC located?

Licking No 1 LLC is located at 209 Hickory St, Licking, MO 65542. The listed phone number is (573) 674-2111.

What is Licking No 1 LLC's specialty?

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

Is Licking No 1 LLC a Medicare-certified nursing home?

Yes. Hickory Manor is a Medicare-certified nursing home with 60 certified beds.

What quality rating does Licking No 1 LLC have?

CMS rates Hickory Manor 2 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Licking No 1 LLC accept?

Health plans from UnitedHealthcare list Licking No 1 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 Licking No 1 LLC was last updated on August 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.