Active NPI
Brooksville Health Care Center LLC
Doing business as Brooksville Healthcare Center
- Skilled Nursing Facility
- Brooksville, FL
National Provider Identifier
1497750954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- SNF 1063096
- Legal business name
- BROOKSVILLE HEALTH CARE CENTER LLC
- Doing business as
- Brooksville Healthcare Center
- Practice address
- 1114 Chatman Blvd
Brooksville, FL 34601-3104 - Phone
- (352) 796-6701
- Fax
- (352) 796-6514
- NPI assigned
- Jun 20, 2005
- Last updated
- Feb 7, 2008
- 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
- Ms. Wanda Moak
- Title
- Administrator
- Phone
- (352) 796-6701
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF 1063096 | FL | Primary |
Addresses
Primary practice location
1114 Chatman Blvd
Brooksville, FL 34601-3104
Mailing address
1114 Chatman Blvd
Brooksville, FL 34601-3104
Phone (352) 796-6701
Other names 1
- Brooksville Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120409000500 | FL | Part A Provider - Skilled Nursing Facility | 6002077658 | Practice locations: Brooksville, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1497750954. Details of each certification follow.
Skilled nursing facility certification: CCN 105297
- Legal name
- BROOKSVILLE HEALTH CARE CENTER LLC
- Doing business as
- BROOKSVILLE HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 20, 1976
- Last certification
- Dec 19, 2024
- Beds
- 180
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- LLC
- Incorporated
- Sep 15, 2000 in DE
- Enrollment address
- 1114 Chatman Blvd
Brooksville, FL 34601-3104 - Nursing home name
- BROOKSVILLE HEALTHCARE CENTER
- Affiliated entity
- HEALTH SERVICES MANAGEMENT
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Brooksville Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Oct 20, 1976
- Medicare certification status
- Active
- Certified beds
- 180
- Chain
- Health Services Management
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0704960 | Brooksville Healthcare Center LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryNetworks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| National Health Investors, Inc. | 5% Or Greater Mortgage Interest | Nov 1, 1990 | 100% |
| Adp of the SNF | Nov 1, 1990 | ||
| Nhi-Reit of Florida, LLC | 5% Or Greater Mortgage Interest | Nov 1, 1990 | 100% |
| Adp of the SNF | Nov 1, 1990 | ||
| Jim Shatz | Corporate Officer | Apr 6, 2021 | |
| Operational/Managerial Control | Apr 2, 2021 | ||
| Candy Pedersen | Adp of the SNF | Feb 12, 2024 | |
| Joshua L White | Corporate Officer | Nov 1, 1990 | |
| Operational/Managerial Control | Nov 1, 1990 | ||
| Brian Jackson | Corporate Officer | Nov 1, 1990 | |
| Operational/Managerial Control | Nov 1, 1990 | ||
| Kevin Baxter | Corporate Officer | Nov 1, 1990 | |
| Operational/Managerial Control | Nov 1, 1990 | ||
| Anitha Kolli | Adp of the SNF | Nov 1, 1990 | |
| Scott Fisher | Corporate Officer | Apr 2, 2012 | |
| Operational/Managerial Control | Nov 1, 1990 | ||
| Health Services Management, Inc. | 5% Or Greater Direct Ownership Interest | Oct 1, 2000 | 100% |
| Operational/Managerial Control | Oct 1, 2000 |
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 5
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Trenton, FL
- NPI 1295781870
Health Services Management, Inc.
-
- Skilled Nursing Facility
- Hudson, FL
- NPI 1285679597
Health Services Management, Inc.
-
dba Cypress Cove Care Center
- Nursing Facility/Intermediate Care Facility
- Crystal River, FL
- NPI 1932100229
Health Services Management, Inc.
-
dba Heather Hill Healthcare Center
- Skilled Nursing Facility
- New Port Richey, FL
- NPI 1982601670
Health Services Management, Inc.
-
- Skilled Nursing Facility
- Dade City, FL
- NPI 1588660922
Health Services Management, Inc.
Practitioners & affiliated clinicians
Affiliated clinicians 4
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": "1119225600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1202342400000",
"number": "1497750954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1114 CHATMAN BLVD",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346013104",
"telephone_number": "352-796-6701",
"fax_number": "352-796-6514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1114 CHATMAN BLVD",
"city": "BROOKSVILLE",
"state": "FL",
"postal_code": "346013104",
"telephone_number": "352-796-6701",
"fax_number": "352-796-6514"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BROOKSVILLE HEALTH CARE CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-20",
"last_updated": "2008-02-07",
"status": "A",
"authorized_official_last_name": "MOAK",
"authorized_official_first_name": "WANDA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "352-796-6701",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": "SNF 1063096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Brooksville Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brooksville, FL
- Mary L Bristow, A.P.
- Jane Smith Brooks, LMHC
- Brooksville Behavioral Health Services, LLC (Sabal Palms Recovery Center)
- Brooksville Chiropractic Inc
- Brooksville Drugs Inc (Benzer Pharmacy)
- Brooksville Hma Physician Management LLC (All Saints Surgery Center)
- Brooksville Hma Physician Management LLC
- Brooksville Hma Physician Management LLC (Bayfront Health Medical Group)
- Brooksville Hma Physician Management LLC
- Brooksville Hma Physician Management LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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.