ANDOVER SENIOR CARE, LLC (NPI# 1689992752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689992752 |
| Entity Type | Organization |
| Organization Name | ANDOVER SENIOR CARE, LLC |
| Other Organization Name | VICTORIA FALLS |
| Practice Address |
224 E Central Ave Andover KS 67002 |
| Mailing Address |
Po Box 906 Andover KS 67002-0906 |
| Practice Telephone | 3167330654 |
| Mailing Telephone | 3167330654 |
| Mailing Fax Number | 3167330995 |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2015-12-07 |
| Authorized Official Name | DENNIS BUSH (CEO) |
| Authorized Official Telephone | 3167332645 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | KANSAS DEPARTMENT ON AGING | N008012 | 01 |
| KS | 200363120A | 05 | |
| KS | PTAN | 175520 | 01 |
| Other Name | Type Code |
|---|---|
| Victoria Falls | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992850432 | Andover Senior Care, LLC | Assisted Living Facility | 408 E Central Ave, Andover, KS 67002-8556 | 2007-01-24 |
| Street Address |
224 E CENTRAL AVE |
| City | ANDOVER |
| State | KS |
| Zip Code | 67002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386262707 | Rachel Marie Porter | Nurse Practitioner | Andover Family Medicine, 2117 N Keystone Circle, Andover, KS 67002 | 2020-07-13 |
| 1033535695 | Michael L Ray | Chiropractor | 1145 N Andover Rd Ste 109, Andover, KS 67002 | 2014-03-06 |
| 1225372949 | Lisa Hua Lee | Physical Therapy Assistant | 811 N Crescent Lakes Cir, Andover, KS 67002 | 2012-11-19 |
| 1033303136 | Casey T Hummel | Chiropractor | 550 North Andover Road, Andover, KS 67002 | 2007-08-31 |
| 1801007786 | Kansas Medical Center, LLC | Family Medicine | 1124 W. 21st St, Andover, KS 67002 | 2007-05-24 |
| 1205929957 | Sitha Uy Miller | Internal Medicine | 943 N. Andover Road, Andover, KS 67002 | 2006-10-02 |
| 1275644650 | Shala Renee Holman | Physician Assistant | 1124 W. 21st Street, Andover, KS 67002 | 2006-08-31 |
| 1497869168 | Allan Michael Weilert | Chiropractor | 202 E Rhondda St, Ste A, Andover, KS 67002 | 2006-08-18 |
| 1407872708 | Lindsay Marie Landers | Family Medicine | 105 S Andover Rd, Suite D, Andover, KS 67002 | 2006-07-14 |
| 1295770782 | Ashley Ralston | Optometrist | 308 E Central Ave Ste 100, Andover, KS 67002 | 2006-06-18 |
| Find all providers in zip 67002 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366497125 | Academy Nursing Home Inc | Skilled Nursing Facility | 89 Morton St, Andover, MA 01810-2036 | 2006-05-23 |
| 1073562021 | Wingate At Andover, Inc. | Skilled Nursing Facility | 80 Andover St, Andover, MA 01810-5606 | 2006-05-08 |
| 1548241185 | Andover Village Retirement Community, Ltd | Skilled Nursing Facility | 486 S Main St, Andover, OH 44003-9602 | 2005-11-10 |
| 1700346459 | Bear Mt Andover LLC | Skilled Nursing Facility | 80 Andover St, Andover, MA 01810-5606 | 2019-03-20 |
| 1730627720 | Alliance Hc Holdings LLC | Skilled Nursing Facility | 1 O'brien Lane, Andover, NJ 07821 | 2017-02-09 |
| 1528506003 | Alliance Hc 11 LLC | Skilled Nursing Facility | 99 Mulford Rd, Andover, NJ 07821-2600 | 2017-02-06 |
| 1164698270 | Accukare Inc | Skilled Nursing Facility | 13750 Crosstown Dr Ste 202, Andover, MN 55304 | 2008-05-08 |
| 1790967511 | 89 Morton Street Operations LLC | Skilled Nursing Facility | 89 Morton St, Andover, MA 01810-2036 | 2007-12-04 |
| 1194771410 | Andover Medical Investors, LLC | Skilled Nursing Facility | 621 W 21st St, Andover, KS 67002-8498 | 2006-05-26 |
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|---|---|---|---|---|
| 1346841152 | Minneapolis Healthcare and Rehabilitation Center LLC | Skilled Nursing Facility | 815n Rothsay Street, Minneapolis, KS 67467 | 2020-11-06 |
| 1487270013 | Americare At Grand Plains Skilled Nursing and Rehabiltation LLC | Skilled Nursing Facility | 331 State Route 61, Pratt, KS 67124 | 2020-06-19 |
| 1144842287 | Logan County Senior Living Inc | Skilled Nursing Facility | 615 Price Ave, Oakley, KS 67748-2048 | 2020-05-12 |
| 1194379065 | Ignite Medical Resort A Ptr of The Univ of Kansas Health System, LLC | Skilled Nursing Facility | 3910 Rainbow Boulevard, Kansas City, KS 66103 | 2019-07-30 |
| 1235604752 | Nortonville Healthcare LLC | Skilled Nursing Facility | 412 Walnut St, Nortonville, KS 66060 | 2018-10-11 |
| 1700383759 | Ranch House Nursing Facility Operations LLC | Skilled Nursing Facility | 2900 N Campus Dr, Garden City, KS 67846-3997 | 2018-04-06 |
| 1902308919 | Center At Waterfront LLC | Skilled Nursing Facility | 1541 North Lindberg Circle, Wichita, KS 67206 | 2018-03-06 |
| 1407355720 | Kingston Trilogy Holdings LLC | Skilled Nursing Facility | 1822 N Brunswick St, Wichita, KS 67212-1588 | 2018-02-02 |
| 1588162382 | Sunporch of Smith Center Inc | Skilled Nursing Facility | 920 E Kansas Ave, Smith Center, KS 66967 | 2018-01-26 |
| 1881104230 | Mount St Mary Inc | Skilled Nursing Facility | 3700 E Lincoln St, Wichita, KS 67218-2008 | 2017-10-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.