NPIMap

Organization Active NPI

Andover Medical Investors, LLC

Doing business as Life Care Center of Andover

  • Skilled Nursing Facility
  • Andover, KS
National Provider Identifier
1194771410
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
N008007 Issued in KS
Legal business name
ANDOVER MEDICAL INVESTORS, LLC
Doing business as
Life Care Center of Andover
Practice address
621 W 21St St
Andover, KS 67002-8498
Phone
(316) 733-1349
Fax
(316) 733-0919
NPI assigned
May 26, 2006
Last updated
Jul 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Authorized official

Name
Cindy S. Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X N008007 KS Primary

Addresses

Primary practice location

621 W 21St St
Andover, KS 67002-8498

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other names 1

  • Life Care Center of Andover Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050930000124 KS Part A Provider - Skilled Nursing Facility 7618902446 Practice locations: Andover, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194771410. Details of each certification follow.

Skilled nursing facility certification: CCN 175157

Legal name
ANDOVER MEDICAL INVESTORS, LLC
Doing business as
LIFE CARE CENTER OF ANDOVER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 31, 1986
Last certification
Mar 27, 2025
Beds
154
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Life Care Centers of America
Most recent change of ownership
Oct 1, 2005
Organization structure
LLC
Enrollment address
621 W 21St St
Andover, KS 67002-8498
Nursing home name
LIFE CARE CENTER OF ANDOVER
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of AndoverCCN 175157 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 31, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
15494.1 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain
Special focus status
SFF Candidate
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
7Fines totaling $114,107

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
17D0451374Life Care Center of Andover621 West 21St Street, Andover, KS 67002Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Indirect Ownership Interest May 13, 2005 100%
Operational/Managerial Control May 13, 2005
Adp of the SNF Oct 1, 2005
Indirect Ownership Interest May 13, 2005 100%
Terry Henry Individual Corporate OfficerAssistant Treasurer of MGMT. Co. Jul 18, 2005
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Oct 1, 2005
Brandon Johnson Individual Operational/Managerial Control Aug 14, 2023
Managing Control - Governing BodyAdministrator Aug 14, 2023
Adp of the SNF Feb 25, 2025
Todd Fletcher Individual Operational/Managerial Control May 1, 2021
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Feb 11, 2025
Aubrey Preston Individual Operational/Managerial Control Nov 27, 2024
Amber Eklund Individual Operational/Managerial Control Apr 9, 2024
Managing Control - Governing BodyDivision Vice President Apr 9, 2024
Joan E Thurmond Individual Corporate OfficerAssistant Secretary of MGMT. Co. Jul 18, 2005
Cindy S Cross Individual Corporate OfficerVP / Assist. Sec. of Management Co. Jul 18, 2005
Yesnia Nelson Individual Operational/Managerial Control Jan 2, 2024
Managing Control - Governing BodyDirector of Nursing Jan 2, 2024
Richard Swanker Individual Operational/Managerial Control Jan 1, 2022
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 13, 2005 100%
Operational/Managerial Control May 13, 2005
Adp of the SNF Oct 1, 2005
Tamara L McCue Individual Operational/Managerial Control Aug 1, 2019
Adp of the SNF Mar 7, 2025
Lisa M Lay Individual Operational/Managerial Control Apr 24, 2017
James Ziegler Individual Operational/Managerial Control May 13, 2005

Owners & managing parties with NPI records 26

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

View all 26

Facilities with the same owner 193

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

View all 193

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783641600000",
    "number": "1194771410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W 21ST ST",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670028498",
            "telephone_number": "316-733-1349",
            "fax_number": "316-733-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDOVER MEDICAL INVESTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "KS",
            "license": "N008007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Andover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Andover, KS

Sources for this page

Verify at the official NPI Registry.