Active NPI
Alegria Living & Healthcare, Inc.
- Skilled Nursing Facility
- Overbrook, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- N070001
- Legal business name
- ALEGRIA LIVING & HEALTHCARE, INC.
- Practice address
- 700 W 7TH St
Overbrook, KS 66524-9496 - Phone
- (785) 665-7124
- Fax
- (785) 665-7026
- NPI assigned
- Sep 2, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Scott G Averill
- Title
- Owner / Administrator
- Phone
- (785) 665-7124
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | |||
| Skilled Nursing Facility | 314000000X | N070001 | KS | Primary |
Addresses
Primary practice location
700 W 7TH St
Overbrook, KS 66524-9496
Mailing address
700 W 7TH St
Overbrook, KS 66524-9496
Phone (785) 665-7124
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1263 | Other | KS | BLUE CROSS BLUE SHIELD |
| 200263560A | Other | KS | HCBS PROVIDER NUMBER |
| 200263730A | Medicaid | KS |
Other names 2
- Brookside Health & Rehab
- Brookside Retirement Community
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040901001293 | KS | Part A Provider - Skilled Nursing Facility | 0244205169 | Practice locations: Overbrook, KS |
Skilled nursing facility certification: CCN 175145
- Legal name
- ALEGRIA LIVING & HEALTHCARE, INC.
- Doing business as
- BROOKSIDE RETIREMENT COMMUNITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 27, 1985
- Last certification
- Dec 11, 2024
- Beds
- 72 (60 certified)
- Ownership / control type
- Corporation
- Multi-facility organization
- Allegria
- Most recent change of ownership
- Jul 1, 2004
- Organization structure
- Corporation
- Enrollment address
- 700 W 7TH St
Overbrook, KS 66524-9496 - Nursing home name
- BROOKSIDE RETIREMENT COMMUNITY
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Brookside Retirement Community
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 27, 1985
- Medicare certification status
- Active
- Certified beds
- 60
- Penalties (3 years)
- 1
National Provider Directory
National Provider Directory- Tax ID family
- Alegria Living Healthcare Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Overbrook, KS
- NPI 1912457953
Ownership & related parties
All disclosed owners & managing parties 11
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Alegria Living & Healthcare, Inc. | 5% Or Greater Direct Ownership Interest | Jul 1, 2014 | 100% |
| Sharrell Davidson | W-2 Managing Employee | Jun 20, 2016 | 100% |
| Operational/Managerial Control | Nov 19, 2024 | ||
| Scott Averill | Contracted Managing Employee | Jan 1, 2024 | 100% |
| 5% Or Greater Direct Ownership Interest | Jul 1, 2004 | 100% | |
| Corporate Officer | Jan 1, 2018 | 100% | |
| Operational/Managerial Control | Nov 13, 2024 | ||
| Adp of the SNF | Nov 22, 2024 | ||
| Direct Ownership Interest | Jul 1, 2004 | 4.99% | |
| Tammy Conklin | W-2 Managing Employee | Jul 13, 2004 | 100% |
| Operational/Managerial Control | Nov 19, 2024 | ||
| Adp of the SNF | Nov 22, 2024 | ||
| Tracy Jones | W-2 Managing Employee | Jul 22, 2024 | 100% |
| Operational/Managerial Control | Nov 19, 2024 | ||
| Adp of the SNF | Nov 22, 2024 | ||
| Susan Averill | Contracted Managing Employee | Jan 1, 2018 | 50% |
| 5% Or Greater Indirect Ownership Interest | Jul 1, 2004 | 50% | |
| Corporate Officer | Jan 1, 2018 | 50% | |
| Operational/Managerial Control | Nov 19, 2024 | ||
| Adp of the SNF | Nov 22, 2024 | ||
| Indirect Ownership Interest | Jul 1, 2004 | 4.99% | |
| Joya Living & Healthcare Inc | Operational/Managerial Control | Nov 13, 2024 | |
| Adp of the SNF | Nov 22, 2024 | ||
| Denise Hoback | Contracted Managing Employee | Jan 1, 2018 | 100% |
| Corporate Officer | Jan 1, 2018 | 100% | |
| Operational/Managerial Control | Nov 13, 2024 | ||
| Adp of the SNF | Nov 22, 2024 | ||
| Nathan Averill | Contracted Managing Employee | Oct 15, 2022 | 100% |
| Operational/Managerial Control | Nov 19, 2024 | ||
| Peggy Wessel | W-2 Managing Employee | Jun 3, 2024 | 100% |
| Operational/Managerial Control | Nov 13, 2024 | ||
| Adp of the SNF | Nov 22, 2024 | ||
| Ciara Jones | W-2 Managing Employee | Oct 13, 2024 | 100% |
| Operational/Managerial Control | Nov 19, 2024 |
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Wellsville, KS
- NPI 1851569818
Joya Living & Healthcare Inc
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Assisted Living Facility
- Overbrook, KS
- NPI 1912457953
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Topeka, KS
- NPI 1649489287
-
- Family Medicine Physician
- Osage City, KS
- NPI 1528357480
-
- Podiatrist
- Overland Park, KS
- NPI 1801901343
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125619200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666742400000",
"number": "1114911237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W 7TH ST",
"city": "OVERBROOK",
"state": "KS",
"postal_code": "665249496",
"telephone_number": "785-665-7124",
"fax_number": "785-665-7026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W 7TH ST",
"city": "OVERBROOK",
"state": "KS",
"postal_code": "665249496",
"telephone_number": "785-665-7124",
"fax_number": "785-665-7026"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALEGRIA LIVING & HEALTHCARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-02",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A",
"authorized_official_last_name": "AVERILL",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER / ADMINISTRATOR",
"authorized_official_telephone_number": "785-665-7124",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "KS",
"license": "N070001",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1263",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCBS PROVIDER NUMBER",
"identifier": "200263560A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200263730A",
"state": "KS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Brookside Health & Rehab",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Brookside Retirement Community",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Overbrook, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.