Andover Medical Investors, LLC
Organization Active NPI Skilled Nursing Facility · Andover, KS
NPI 1194771410 · NPPES record last updated Jul 10, 2026
Key facts
- NPI
- 1194771410
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- N008007 (KS)
- Legal business name
- ANDOVER MEDICAL INVESTORS, LLC
- Practice address
- 621 W 21St St
Andover, KS 67002-8498 - Phone
- (316) 733-1349
- Fax
- (316) 733-0919
- NPI assigned
- May 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Cindy S. Cross
- Title
- Assistant Secretary
- Phone
- (423) 473-5867
Owners & managing parties with NPI records 26
-
Tamara L McCue, D.O.
Member of 1
Facilities with the same owner 193
Practitioners 1
-
Tamara L McCue, D.O.
Medicare Care Compare: Nursing home
- Listed as
- Life Care Center of Andover
- 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
- Active
- Certified beds
- 154 · 94.1 residents per day on average
- Chain
- Life Care Centers of America
- Special focus status
- SFF Candidate
- Abuse citation
- Cited for abuse (Care Compare abuse icon)
- Penalties (3 years)
- 7 · fines totaling $114,107
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D0451374 | Life Care Center of Andover | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
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
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Forrest L Preston |
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 |
Corporate Officer |
Jul 18, 2005 | |
| |
Adp of the SNF | Oct 1, 2005 | |
| Brandon Johnson |
Operational/Managerial Control | Aug 14, 2023 | |
| Managing Control - Governing Body |
Aug 14, 2023 | ||
| Adp of the SNF | Feb 25, 2025 | ||
| Todd Fletcher |
Operational/Managerial Control | May 1, 2021 | |
| |
Adp of the SNF | Feb 11, 2025 | |
| Aubrey Preston |
Operational/Managerial Control | Nov 27, 2024 | |
| Amber Eklund |
Operational/Managerial Control | Apr 9, 2024 | |
| Managing Control - Governing Body |
Apr 9, 2024 | ||
| Joan E Thurmond |
Corporate Officer |
Jul 18, 2005 | |
| Cindy S Cross |
Corporate Officer |
Jul 18, 2005 | |
| Yesnia Nelson |
Operational/Managerial Control | Jan 2, 2024 | |
| Managing Control - Governing Body |
Jan 2, 2024 | ||
| Richard Swanker |
Operational/Managerial Control | Jan 1, 2022 | |
| Life Care Centers of America, Inc. |
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 |
Operational/Managerial Control | Aug 1, 2019 | |
| Adp of the SNF | Mar 7, 2025 | ||
| Lisa M Lay |
Operational/Managerial Control | Apr 24, 2017 | |
| James Ziegler |
Operational/Managerial Control | May 13, 2005 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050930000124 | KS | Part a Provider - Skilled Nursing Facility | 7618902446 | Practice locations: Andover, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | N008007 | KS | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100108010A | Medicaid | KS |
Other names
- Life Care Center of Andover
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Andover, KS
- Andover Ambulatory Surgery Center, LLC
- Andover Chiropractic Center, Inc.
- Andover Family Counseling, LLC
- Andover Family Medicine, LLC
- Andover KS Opco LLC
- Andover Senior Care, LLC
- Andover Senior Care, LLC
- Andover Usd 385
- Ghanem A Aouad
- Aquarius Home Health
All providers in Andover, KS · Skilled Nursing Facility in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.