Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1912424607 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1912424607","entity_type_code":"2"} |
| pac_id | 0345507521 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1912424607","rule":"D-PECOS","enrlmt_id":"O20171122002453","pecos_asct_cntl_id":"0345507521"} |
| pecos_enrlmt_id | O20171122002453 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1912424607","rule":"D-PECOS","enrlmt_id":"O20171122002453"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | JONATHAN BEERS (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"09/01/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0244419851","source_pk":174329,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | OWNER PAC 0941717219 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/01/2000","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0941717219","source_pk":174331,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | SOVEREIGN HEALTHCARE GROUP LLC (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"04/23/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2365827185","source_pk":174332,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | FG LLC (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2668991068","source_pk":174334,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | MID STATES INC (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2769901164","source_pk":174335,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | VAN DE VEN LLC (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3577082973","source_pk":174336,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | OWNER PAC 3678080942 | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"01/01/2000","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"3678080942","source_pk":174337,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | TODD BEAIRD | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/01/2022","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4789079096","source_pk":174338,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | DONALD B BEDELL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"05/24/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5092623827","source_pk":174340,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | ANGIE WARNER | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"06/16/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5496262768","source_pk":174341,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | THE LICKING EXEMPT TRUST (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"71","association_date":"05/24/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"5597022715","source_pk":174343,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"71","role_text_owner":"TRUSTEE OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | TINA CAUDILL | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/15/2026","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6901383744","source_pk":174345,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | FORVIS MAZARS LLP (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/16/2021","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"7416866603","source_pk":174347,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | AGH1 LLC (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"08/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"8123547528","source_pk":174348,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | THE CITY OF LICKING (MO) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"72","association_date":"08/01/2017","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9133636400","source_pk":174350,"type_owner":"O","enrollment_id":"O20171122002453","role_code_owner":"72","role_text_owner":"ADP OF THE SNF","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
| ← owns | LINDI DIANA SCHMITT | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"11/27/2023","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"9830606102","source_pk":174351,"type_owner":"I","enrollment_id":"O20171122002453","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"LICKING NO 1 LLC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1912424607 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| dba_name | <UNAVAIL> | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2017-08-24 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | LICKING NO 1 LLC | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | MO | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 314000000X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1912424607: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
14-tuple provenance (26)
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
14-tuple provenance (1)
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
14-tuple provenance (1)
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…