NPIMap

Organization Active NPI

College Hills Opco, LLC

Doing business as Legacy at College Hill

  • Skilled Nursing Facility
  • Wichita, KS
National Provider Identifier
1144690785
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COLLEGE HILLS OPCO, LLC
Doing business as
Legacy at College Hill
Practice address
5005 E 21St St N
Wichita, KS 67208-1604
Phone
(316) 685-9291
NPI assigned
Sep 25, 2015
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Isaac Dole
Title
Manager
Phone
(773) 645-9246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

5005 E 21St St N
Wichita, KS 67208-1604

Mailing address

2045 W Grand Ave Ste B-34572
Chicago, IL 60612-1576
Phone (773) 645-9246

Other names 1

  • Legacy at College Hill Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160603001676 KS Part A Provider - Skilled Nursing Facility 8921398967 Practice locations: Wichita, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144690785. Details of each certification follow.

Skilled nursing facility certification: CCN 175078

Legal name
COLLEGE HILLS OPCO, LLC
Doing business as
LEGACY AT COLLEGE HILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1969
Last certification
Feb 13, 2025
Beds
85 (75 certified)
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
5005 E 21St St N
Wichita, KS 67208-1604
Nursing home name
LEGACY AT COLLEGE HILL
Affiliated entity
CAMPBELL STREET SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Horizon Post AcuteCCN 175078 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 1969
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7561.1 residents per day on average
Chain
Campbell Street Services22 facilities in the chain
Penalties (3 years)
3Fines totaling $43,188

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0648322Legacy on College Hill5005 East 21St Street North, Wichita, KS 67208Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Isaac S Dole Individual Corporate OfficerManager Oct 31, 2015 100%
Adp of the SNF Jan 17, 2025
Indirect Ownership Interest Nov 1, 2015 2%
College Hills Realco, LLC Organization, Chicago, IL Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2015 100%
Adp of the SNF Nov 1, 2015
KS Portfolio Master SNF Holdco, LLC Organization, Chicago, IL Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2015 100%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 100%
John Adams Individual 5% Or Greater Indirect Ownership InterestInvestor Nov 1, 2015 6.52%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 6.52%
Amy Fox Individual Operational/Managerial Control Apr 3, 2025
Adp of the SNF Apr 3, 2025
Isidore Mendelovitz Individual 5% Or Greater Indirect Ownership InterestInvestor Nov 1, 2015 16.29%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 16.29%
Vinay Tolia Individual 5% Or Greater Indirect Ownership InterestInvestor Nov 1, 2015 5.7%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 5.7%
Steven Griffin Individual Operational/Managerial Control Oct 28, 2024
Adp of the SNF Oct 28, 2024
KS Portfolio Master Holdco, LLC Organization, Chicago, IL Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2015 100%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 100%
Rodney K Bryant Individual Operational/Managerial Control Jan 1, 2018
Adp of the SNF Jan 1, 2018
KS Portfolio Investor, LLC Organization, Chicago, IL Created for acquisition, LLC, Investment firm, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 31, 2015 95%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 95%
Jordan Fishfeld Individual 5% Or Greater Indirect Ownership InterestInvestor Nov 1, 2015 11.1%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 11.1%
Campbell Street Services LLC Organization, Chicago, IL LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Mar 1, 2022
Adp of the SNF Mar 13, 2025
Sanjay Tolia Individual 5% Or Greater Indirect Ownership InterestInvestor Nov 1, 2015 5.7%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 5.7%
Kirit K Tolia Individual 5% Or Greater Indirect Ownership InterestInvestor Nov 1, 2015 6.52%
Indirect Ownership Interest Nov 1, 2015 6.52%
KS Portfolio Sponsor, LLC Organization, Chicago, IL Created for acquisition, LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2015 5%
Indirect Ownership Interest Nov 1, 2015 5%
Nkero Investments LTD LLP Organization, Chicago, IL Investment firm, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2015 9.77%
Adp of the SNF Nov 1, 2015
Indirect Ownership Interest Nov 1, 2015 9.77%
KS Portfolio Manager, LLC Organization, Chicago, IL LLC Operational/Managerial Control Nov 1, 2015

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 21

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 21

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1144690785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 W GRAND AVE STE B-34572",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121576",
            "telephone_number": "773-645-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672081604",
            "telephone_number": "316-685-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE HILLS OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "DOLE",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-645-9246"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy at College Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.